Nursing Assistant - Nurse Aid Exam, 2ed

NURSING ASSISTANT/
NURSE AIDE
EXAM
NURSING
ASSISTANT/
NURSE
AIDE
EXAM
2nd Edition
NEW YORK
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:

900 Broadway
Suite 604
New York, NY 10003
Or visit us at:
www.learnatest.com
List of Contributors
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.
v
Contents
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
vii
NURSING ASSISTANT/
NURSE AIDE
EXAM
C H A P T E R
The Nursing
1 Assistant/Nurse
Aide Exam
CHAPTER SUMMARY
This chapter introduces you to the certification process for nursing
assistants and shows you how to use this book to help you prepare
for the exam to become a Certified Nursing Assistant (CNA).
I N 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.
1
– THE NURSING ASSISTANT/NURSE AIDE EXAM –
Finding Out about and equipment. As a CNA, your training will consist of
Certification Requirements learning to perform the following basic duties:
If you want to become a CNA, the first step is to con- ■ communicating with the patient and others on
tact your local community or state health agency to the job
obtain certification requirements. You can find these ■ bathing and dressing the patient (general skin
agencies listed in the blue (government) pages of your care and hygiene)
phone book. You can also contact an employment ■ helping patients out of bed
agency or the healthcare facility you want to work for, ■ setting up and storing medical equipment
since they will often be able to guide you through the ■ taking vital signs—pulse, blood pressure, temper-
training and certification requirements. To give you an ature, and respiration
idea of what to expect, see Chapter 9 for an outline of ■ feeding the patient
some of the current trends in CNA certification. ■ changing bed linens
OBRA laws also require that a state registry be ■ cleaning bedpans and measuring urine output
kept for CNAs. Information such as dates of certifica- ■ answering patients’ calls and delivering messages
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. Career Outlook and
Earning Potential
Education and Training The nursing assistant profession, on the whole, is

growing faster than average. Nurse aides held about
Healthcare facilities usually require CNAs to have a 1.4 million jobs in 1998, and that number is expected
high school diploma or GED and to pass a state- to increase by almost 25% by 2008. While job pros-
approved training program that consists of anywhere pects are good, the salaries tend to be low. Hourly
from 75 to 150 hours of training. You can be hired wages range from about $6.00 to $12.00, depending on
without being certified, but you must receive certifica- which part of the country you live in. Salaries in the
tion within four months after your hire date. While the Northeast are highest, while the South is lower paying.
duties of a nursing assistant vary depending on the If you have five years of experience or more, your pay
workplace, the job emphasis is always on the physical increases by a few dollars per hour. Paid holidays, hos-
and emotional well-being of the patient. While a day in pital and medical benefits, extra pay for overtime, and
the life of a CNA is not easy, especially when dealing pension plans are available to many hospital and some
with a difficult patient, most CNAs get great satisfac- nursing home employees.
tion from their work. Common characteristics for Once you know what you have to do to be certi-
someone considering this profession are dedication, fied in your state, you can begin to plan your CNA
patience, reliability, and compassion. Another key ele- study program. Go to a local job counseling center,
ment to the job is the ability to communicate and work state employment agency, or private healthcare job
well with others. A CNA must also be physically able to placement service to get information about how to get
perform the job—such as standing for a good portion the training you need to become a CNA. Many health-
of an eight-hour day and lifting and moving objects care agencies will provide you with the training you
need. Or you may be able to prepare on your own and
2
simply go in to demonstrate your competence by tak- ■ Client’s Rights—such as privacy, grievances,

ing a written exam, demonstrating your skills in a client and family group participation, physical
practical exam, or both. Whether you are involved in a and chemical restraints, personal possessions, and
training class or working on your own, you should be more
using textbooks and other materials that will train you ■ Employability Skills—such as acquiring a job and
in the most important skills a CNA needs. Such books maintaining a job
will be available in public libraries and college book-
stores; job search agencies may also have some supple- Even if your state or agency doesn’t require a
mental materials available. 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,
How to Use This Book you are ready to take the first practice exam in this
book. Each practice exam contains 70 multiple-choice
Many state and local agencies require a written exam questions on all aspects of the job. Allow yourself
consisting of approximately 70 multiple-choice ques- enough time to complete the entire exam at one sit-
tions as part of the certification process for CNAs. This ting, approximately two-and-a-half hours.
book contains five practice written exams, based on Each practice exam has an answer key at the end,
the national standards, that contain questions about all which not only tells you the right answer, but also
the skills you will use as a CNA. The written portion of explains why that answer is right. In general, you
the nursing assistant exam consists of multiple-choice should count yourself successful when you can score at
questions, while the clinical portion has the test taker least 75%. If you don’t get that score on the first prac-
performing five on-the-job skills. Some of the skills tice exam, don’t panic! First, review the answer expla-
tested include: nations to see where you went wrong. Then, see which
areas you did well in and which areas gave you more
■ Personal Care Skills—such as client bathing, trouble. Go back to your textbook or other training
grooming, dressing, toileting, skin care, nutrition, materials to review your weakest areas. Then take the
and more second practice exam. You should find that your score
■ Basic Nursing Skills—such as providing a safe improves. Continue this process—reviewing, taking a
and/or clean environment, recognizing abnormal practice exam, more review—until you have com-
signs or symptoms of diseases and conditions, pleted all five practice exams in this book. That way
communicating with clients, understanding basic you will be well prepared for any state certification
principles of infection and control, and more exam you may have to take.
■ Mental Health and Social Service Needs—such as Practice with the exams in this book is not a
psychosocial characteristics of populations, iden- guarantee that you will pass a state certification
tification of developmental tasks associated with exam—or get a job as a CNA. But it certainly does
aging, behavior management, and so on bring you closer to those goals than if you had not
■ Basic Restorative Devices—use of assistive studied and prepared!
devices, range of motion, client transfer, bowel In addition to the practice written exams, this
and bladder training, and care and use of pros- book also includes a sample performance assessment
thetic devices 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 Nursing Assistant State
exam or by a prospective employer during a job inter- Registries
view. You should practice these tasks and become pro- ALABAMA
ficient enough to perform them under pressure with Department of Public Health
an examiner or your potential employer watching you Division of License and Certification
434 Monroe Street
closely. Carefully practicing these skills will help you
Moffitt Building
sell yourself to your employer and will put you ahead Montgomery, AL 36130-3017
of other people applying for the same position. Keep in 334-261-6505
mind that the best-trained person is usually the one ALASKA
who is selected for the position. Division of Occupational Licensing
Here are the steps to take to become a CNA: Alaska State Board of Nursing
3601 C Street, #722
Anchorage, AK 99503
1. Contact local employment agencies or the state 907-561-2878
health office to find out about certification stan-
ARIZONA
dards. (A list of state registries follows.) Arizona State Board of Nursing
2. Contact local employment agencies for employ- 1651 East Morten, Suite 150
ment opportunities. Phoenix, AZ 85020
3. Take your CNA course and/or use study guides 520-255-5455
and textbooks to prepare for certification. ARKANSAS

4. Take the first practice exam in this book and Department of Human Services
Division of Medical Services
score it. Review your weakest areas.
Mail Slot 405, P.O. Box 8059
5. Continue to review and take practice exams. Little Rock, AR 72203-8059
Score yourself on each exam to see how prepared 501-682-8484
you are for the actual certification exam. CALIFORNIA
6. Once you feel confident, contact your state or Department of Health Services
local agency to set a date for taking the certifica- Division of Licensing and Certification
P.O. Box 942732
tion exam.
Sacramento, CA 94234-7320
7. Take the certification exam and pass it! 916-327-2445
8. Show prospective employers your certificate.
COLORADO
This shows you are ready to start a job and have
Department of Regulatory Agencies
the initiative to advance once you are hired. State Board of Nursing
1560 Broadway, #670
If you faithfully follow these steps, you will be Denver, CO 80202
303-894-2816
well on your way to a successful career as a certified
nursing assistant. CONNECTICUT
Assessment Systems, Inc.
Processing Center Suite 300
3 Bala Plaza West
Bala Cynwyd, PA 19004-3481
800-274-2900
4
DELAWARE IOWA
Division of Public Health Department of Inspections and Appeals
Health Facilities Licensing and Certification Health Facilities Division
3 Mill Road, Suite 308 Lucas State Office Building
Wilmington, DE 19800 Des Moines, IA 50319-0083
302-577-6666 515-281-4963
DISTRICT OF COLUMBIA KANSAS

Department of Consumer and Regulatory Affairs Department of Health and Environment
614 H Street NW, #1003 Health Occupation Credential Unit
Washington, DC 20001 109 SW 9th Street, Suite 400B
202-727-7190 Topeka, KS 66612-2218
913-296-6877
FLORIDA
Agency for Health Care Administration KENTUCKY
2727 Mahen Drive Cabinet for Human Resources
Tallahassee, FL 32308 Division of Licensing and Regulation
904-488-8401 274 East Main Street
CHR Building, 4th Floor East
GEORGIA Frankfort, KY 40621
Georgia Nurse Aide Registry 502-564-2800
Georgia Department of Human Resources
2 Peachtree Street, NW, 21st Floor LOUISIANA
Atlanta, GA 30303-3167 Board of Examiners for Nursing Home
404-657-5730 Administrators
5615 Corporate Boulevard, Suite 8D
HAWAII Baton Rouge, LA 70808
Nurse Assistant Competency Testing 504-925-4591
American Red Cross, Hawaii Chapter
4155 Diamond Head Road MAINE
Honolulu, HI 96816-4417 Department of Human Resources—CNA Registry
808-734-2101 State House Station 11
Fax: 808-734-8318 35 Anthony Avenue
Augusta, ME 04333
IDAHO 207-287-3707
Idaho Board of Nursing
P.O. Box 83720 MARYLAND
Boise, ID 83720-0061 Maryland CNA Registry
208-334-3110 Psychological Corporation
P.O. Box 839963
ILLINOIS San Antonio, TX 78283-9963
Department of Public Health Education 800-622-3231
525 West Jefferson
Springfield, IL 62761 MASSACHUSETTS
217-782-3070 Department of Public Health
Division of Health Care Quality
INDIANA 10 West Street
State Board of Health Boston, MA 02111
1330 West Michigan
617-727-5860
P.O. Box 1964
Indianapolis, IN 46206-1964 MICHIGAN
317-383-6612 or 317-633-0639 Health Management Associates
120 North Washington Square, #905
Lansing, MI 48933
517-371-9091 or 800-748-0252
5
MINNESOTA NEW HAMPSHIRE

Minnesota Department of Health New Hampshire Board of Nursing
Facility and Provider Compliance Division Division of Public Health Services
Nurse Assistant Registry 6 Hazen Drive
393 North Dunlap Street Concord, NH 03301
P.O. Box 64501 603-271-6282 or 603-271-6599
St. Paul, MN 55164-0501
612-643-2176 or 800-397-6124
NEW JERSEY
Assessment Systems, Inc.
MISSISSIPPI Processing Center, Suite 300
Mississippi Board of Nursing 3 Bala Plaza West
239 North Lamar, #401 Bala Cynwyd, PA 19004-3481
Jackson, MS 39201 800-274-2900
601-359-6182
NORTH CAROLINA
MISSOURI Department of Health and Human Services
Health Education Unit Division of Facility Services
Division of Aging Nurse Aide Training and Registry Administration
P.O. Box 1337 2709 Mail Service Center
Jefferson City, MO 65102 Raleigh, NC 27699-2709
314-571-3082 or 314-526-5686 (voice mail) 919-733-2786
Voice Response System: 919-715-0562
MONTANA www.ncnar.org
Department of Health
Licensing and Certification Bureau NORTH DAKOTA
Cogswell Building, Room C-211 North Dakota Department of Health Division of
Helena, MT 59620 Emergency Health Services
406-444-2037 600 E Blvd Avenue, Department 301
Bismarck, ND 58505-0200
NEBRASKA 701-328-2388
Department of Health Fax: 701-328-1890
Bureau of Health Facility Standards
E-mail: ckupfer@state.nd.us
301 Centennial Mall South
P.O. Box 95007 OHIO
Lincoln, NE 68509-5007 Department of Health
402-471-0537 Nurse Aide Unit
P.O. Box 118
NEVADA Columbus, OH 43266-0118
State Board of Nursing 800-582-5908 or 614-752-9500
1755 East Plumb Lane, Suite 260
Reno, NV 89502 OKLAHOMA
702-786-2778 or 702-739-0129 Oklahoma State Department of Health
1000 NE 10th Street
NEW MEXICO Oklahoma City, OK 73117-1299
Department of Health 800-695-2157
Licensing and Certification
P.O. Box 26110 OREGON
Santa Fe, NM 87501 Board of Nursing, Program Executive
505-827-4206 800 Northeast Oregon Street, Suite 465
Fax: 505-827-4203 Portland, OR 97232
503-731-4745
6
PENNSYLVANIA VERMONT
Department of Health Vermont Board of Nursing
Division of Long Term Care 109 State Street
P.O. Box 90, Room #526 Secretary of State Office
Harrisburg, PA 17108 Montpelier, VT 05609-1106
717-787-1816 802-828-2819
RHODE ISLAND VIRGINIA

Department of Health Department of Health Professionals
Division of Professional Regulation Board of Nursing
3 Capitol Hill, Room 104 6606 West Broad Street, 4th Floor
Providence, RI 02098 Richmond, VA 23230-1717
401-277-2827 804-662-7310
SOUTH CAROLINA WASHINGTON

Department of Health and Environment Department of Social and Health Services
2600 Bull Street OBRA Nursing Assistant Registry
Columbia, SC 29201 P.O. Box 45600
803-737-7207 Olympia, WA 98504-5600
360-438-7925
SOUTH DAKOTA
Board of Nursing WEST VIRGINIA
3307 S. Lincoln Avenue Health Facility Licensure and Certification
Sioux Falls, SD 57105 1900 Kanawha Boulevard East, Building #3
605-367-5940 Charleston, WV 25305
Fax: 605-367-5945 304-558-0050
TENNESSEE WISCONSIN
Department of Health Department of Health and Social Services
283 Plus Park Boulevard Bureau of Quality Compliance
Nashville, TN 37247-0530 1 West Wilson Street
615-367-6344 P.O. Box 2569
Madison, WI 53701
TEXAS 608-267-2374
Department of Human Services
Nurse Aide Registry WYOMING
P.O. Box 149030, Mail Code Y-977 State Board of Nursing
Austin, TX 78714-9030 2020 Carey Street, Suite 110
512-834-6670 Cheyenne, WY 82002
307-777-7601
UTAH
Nurse Aide Registry
550 East 300 South
Kaysville, UT 84037
801-547-9947
7
C H A P T E R
The
2 LearningExpress
Test Preparation
System
CHAPTER SUMMARY
Taking a nursing assistant certification exam can be tough, and
your career in healthcare depends on your passing the exam.
The LearningExpress Test Preparation System, developed exclusively
for LearningExpress by leading test experts, gives you the discipline
and attitude you need to succeed.
F I 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
9
– THE LEARNINGEXPRESS TEST PREPARATION SYSTEM –
What’s the common denominator in all these Step 1: Get Information

test-taking pitfalls? One word: control. Who’s in con-
trol, you or the exam? Activities: Read Chapter 1, “The Nursing Assistant
Now the good news: The LearningExpress Test Exam,” and use the suggestions there to find out
Preparation System puts you in control. In just nine about your certification requirements.
easy-to-follow steps, you will learn everything you Knowledge is power. Therefore, first, you have to find
need to know to make sure that you are in charge of out everything you can about the nursing assistant
your preparation and your performance on the exam. exam. Once you have your information, the next steps
Other test-takers may let the test get the better of them; will show you what to do about it.
other test-takers may be unprepared or out of shape—
but not you. You will have taken all the steps you need Part A: Straight Talk about the
to take to get a high score on the nursing assistant Nursing Assistant Exam
exam. Why do you have to take this exam, anyway? Because
Here’s how the LearningExpress Test Preparation an increasing number of people, particularly elderly
System works: Nine easy steps lead you through every- people, need to be cared for. And, since more and more
thing you need to know and do to get ready to master people need these services, there is growing concern
your exam. Each of the steps listed below includes both about the quality of care the patients get. One way to
reading about the step and one or more activities. It is try to ensure quality of care is to test the people who
important that you do the activities along with the give that care to find out if they have been well trained.
reading, or you won’t be getting the full benefit of the And that’s why your state or the agency you want to
system. work for may require you to take a written exam.
It is important for you to remember that your
Step 1. Get Information score on the written exam does not determine how
Step 2. Conquer Test Anxiety smart you are or even whether you will make a good
Step 3. Make a Plan nursing assistant. There are all kinds of things a writ-
Step 4. Learn to Manage Your Time ten exam like this can’t test: whether you are likely
Step 5. Learn to Use the Process of Elimination to show up late or call in sick a lot, whether you can
Step 6. Know When to Guess be patient with a trying client, or whether you can be
Step 7. Reach Your Peak Performance Zone trusted with confidential information about people’s
Step 8. Get Your Act Together health. Those kinds of things are hard to evaluate on a
Step 9. Do It! written exam. Meanwhile, it is easy to evaluate whether
you can correctly answer questions about the job
If you have several hours, you can work through duties of a nursing assistant/nurse aide.
the whole LearningExpress Test Preparation System in This is not to say that correctly answering the
one sitting. Otherwise, you can break it up and do just questions on the written exam is not important! The
one or two steps a day for the next several days. It is up knowledge tested on the exam is knowledge you will
to you—remember, you are in control. 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.
10
Part B: What’s on the Test Stress Management

If you haven’t already done so, stop here and read Before the Test
Chapter 1 of this book, which gives you an overview of If you feel your level of anxiety getting the best of you
the written exam. Chapter 1 also suggests ways to find in the weeks before the test, here is what you need to
out about certification requirements in your state. do to bring the level down again:
At this point, you may also want to skip ahead to
Chapter 9 to uncover some of the trends in healthcare ■ Get prepared. There’s nothing like knowing what
licensing requirements. Later, you will have the oppor- to expect and being prepared for it to put you in
tunity to take the sample practice exams in Chapters 3 control of test anxiety. That’s why you are reading
through 7. Chapter 8 will help you go through the clin- this book. Use it faithfully, and remind yourself
ical skills area of the test. that you are better prepared than most of the
people taking the test.
■ Practice self-confidence. A positive attitude is a
Step 2: Conquer Test Anxiety great way to combat test anxiety. This is no time
to be humble or shy. Stand in front of the mirror
Activity: Take the Test Anxiety Quiz on page 12. and say to your reflection, “I’m prepared. I’m full
Having complete information about the exam is the of self-confidence. I’m going to ace this test. I
first step in getting control of the exam. Next, you have know I can do it.” If you hear it often enough, you
to overcome one of the biggest obstacles to test success: will come to believe it.
test anxiety. Test anxiety cannot only impair your per- ■ Fight negative messages. Every time someone
formance on the exam itself; it can even keep you from starts telling you how hard the exam is or how it
preparing! In this step you will learn stress manage- is almost impossible to get a high score, start
ment techniques that will help you succeed on your telling them your self-confidence messages above.
exam. Learn these strategies now, and practice them as If the someone with the negative messages is you,
you complete the exams in this book so that they will telling yourself you don’t do well on exams or you
be second nature to you by exam day. just can’t do this, don’t listen.
■ Visualize. Imagine yourself reporting for duty on
Combating Test Anxiety your first day as a certified nursing assistant.
The first thing you need to know is that a little test anx- Think of yourself helping patients and making
iety is a good thing. Everyone gets nervous before a big them more comfortable. Imagine coming home
exam—and if that nervousness motivates you to pre- with your first paycheck. Visualizing success can
pare thoroughly, so much the better. Many well-known help make it happen—and it reminds you of why
people throughout history have experienced anxiety or you are working so hard to pass the exam.
nervousness—from performers such as actor Sir Lau- ■ Exercise. Physical activity helps calm down your
rence Olivier and singer Aretha Franklin to writers body and focus your mind. Besides, being in good
such as Charlotte Brontë and Alfred Lord Tennyson. In physical shape can actually help you do well on
fact, anxiety probably gave them a little extra edge— the exam. Go for a run, lift weights, go swim-
just the kind of edge you need to do well, whether on ming—and do it regularly.
a stage or in an examination room.
Stop here and complete the Test Anxiety Quiz on Stress Management on Test Day
the next page to find out whether your level of test There are several ways you can bring down your level
anxiety is something you should worry about. 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 break.” Put down your pencil, close your eyes, and
which ones work best for you. do some deep breathing for a few seconds. Then
you will be ready to go back to work.
■ Deep breathing. Take a deep breath while you
count to five. Hold it for a count of one, then let Try these techniques ahead of time, and see if
it out for a count of five. Repeat several times. they don’t work for you!
■ Move your body. Try rolling your head in a circle.
Rotate your shoulders. Shake your hands from
the wrist. Many people find these movements Step 3: Make a Plan
very relaxing.
■ Visualize again. Think of the place where you are Activity: Construct a study plan.
most relaxed: lying on the beach in the sun, walk- Maybe the most important thing you can do to get
ing through the park, or whatever makes you feel control of yourself and your exam is to make a study
good. Now close your eyes and imagine you are plan. Too many people fail to prepare simply because
actually there. If you practice in advance, you will they fail to plan. Spending hours poring over sample
find that you only need a few seconds of this test questions the day before the exam not only raises
exercise to experience a significant increase in your level of test anxiety, but it also will not replace
your sense of well-being. careful preparation and practice over time.
Don’t fall into the cram trap. Take control of your
When anxiety threatens to overwhelm you right preparation time by mapping out a study schedule. On
there during the exam, there are still things you can do the following pages are two sample schedules, based on
to manage the stress level. the amount of time you have before you take the writ-
ten exam. If you are the kind of person who needs
■ Repeat your self-confidence messages. You deadlines and assignments to motivate you for a proj-
should have them memorized by now. Say them ect, here they are. If you are the kind of person who
quietly to yourself, and believe them! doesn’t like to follow other people’s plans, you can use
■ Visualize one more time. This time, visualize the suggested schedules here to construct your own.
yourself moving smoothly and quickly through Even more important than making a plan is
the test answering every question correctly and making a commitment. You can’t review everything
finishing just before time is up. Like most visuali- you learned in your nursing assistant course in one
zation techniques, this one works best if you have night. You need to set aside some time every day for
practiced it ahead of time. study and practice. Try for at least 20 minutes a day.
■ Find an easy question. Skim over the test until Twenty minutes daily will do you much more good
you find an easy question, and answer it. Getting than two hours on Saturday—divide your test prepa-
even one circle filled in gets you into the test- ration into smaller pieces of the larger work. In addi-
taking groove. tion, making study notes, creating visual aids, and
■ Take a mental break. Everyone loses concentra- memorizing can be quite useful as you prepare. Each
tion once in a while during a long test. It is nor- time you begin to study, quickly review your last les-
mal, so you shouldn’t worry about it. Instead, son. This act will help you retain all you have learned
accept what has happened. Say to yourself, “Hey, and help you assess if you are studying effectively. You
I lost it there for a minute. My brain is taking a may realize you are not remembering some of the
13
material you studied earlier. Approximately one week in the use of mnemonics are imagination, association,
before your exam try to determine the areas that are and location. Acronyms (words created from the first
still most difficult for you. letters in a series of words) are common mnemonics.
Don’t put off your study until the day before the One acronym you may already know is HOMES, for
exam. Start now. A few minutes a day, with half an the names of the Great Lakes (Huron, Ontario, Michi-
hour or more on weekends, can make a big difference gan, Erie, and Superior). ROY G. BIV reminds people
in your score. of the colors in the spectrum (Red, Orange, Yellow,
Green, Blue, Indigo, and Violet). Depending on the
Learning Styles type of learner you are, mnemonics can also be color-
Each of us absorbs information differently. Whichever ful or vivid images, stories, word associations, or catchy
way works best for you is called your dominant learning rhymes such as “Thirty days hath September . . . ” cre-
method. If someone asks you to help them construct a ated in your mind. Any type of learner, whether visual,
bookcase they just bought, that may be in many pieces, auditory, or kinesthetic, can use mnemonics to help
how do you begin? Do you need to read the directions the brain store and interpret information.
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? Step 4: Learn to Manage
The three main learning methods are visual, Your Time
auditory, and kinesthetic. Determining which type of
learner you are will help you create tools for studying. Activities: Practice these strategies as you take the
sample tests in this book.
Visual Learners need to see the information in the Steps 4, 5, and 6 of the LearningExpress Test Prepara-
form of maps, pictures, text, words, or math exam- tion System put you in charge of your exam by show-
ples. Outlining notes and important points in col- ing you test-taking strategies that work. Practice these
orful highlighters and taking note of diagrams and strategies as you take the sample tests in this book, and
pictures may be key in helping you study. then you will be ready to use them on test day.
First, you will take control of your time on the
Auditory Learners retain information when they can
exam. Most nursing assistant exams have a time limit,
hear directions, the spelling of a word, a math the-
which may give you more than enough time to com-
orem, or poem. Repeating information aloud or lis-
plete all the questions—or may not. It is a terrible feel-
tening to your notes on a tape recorder may help.
ing to hear the examiner say, “Five minutes left,” when
Many auditory learners also find working in study
you are only three-quarters of the way through the test.
groups or having someone quiz them is beneficial.
Here are some tips to keep that from happening to
Kinesthetic Learners must do! They need to draw dia- you.
grams, write directions, etc. Rewriting notes on
index cards or making margin notes in your text- ■ Follow directions. If the directions are given
books also helps kinesthetic learners to retain orally, listen to them. If they are written on the
information. exam booklet, read them carefully. Ask questions
before the exam begins if there’s anything you
Mnemonics don’t understand. If you are allowed to write in
Mnemonics are memory tricks that help you remem- your exam booklet, write down the beginning
ber what you need to know. The three basic principles time and the ending time of the exam.
14
■ Pace yourself. Glance at your watch every few Which of the following lists of signs and symp-
minutes, and compare the time to how far you toms indicates a possible heart attack?
have gotten in the test. When one-quarter of the a. headache, dizziness, nausea, confusion
time has elapsed, you should be a quarter of b. dull chest pain, sudden sweating, difficulty
the way through the test, and so on. If you are breathing
falling behind, pick up the pace a bit. c. wheezing, labored breathing, chest pain
■ Keep moving. Don’t dither around on one ques- d. difficulty breathing, high fever, rapid pulse
tion. If you don’t know the answer, skip the
question and move on. Circle the number of the You should always use the process of elimination
question in your test booklet in case you have on a question like this, even if the right answer jumps
time to come back to it later. out at you. Sometimes the answer that jumps out isn’t
■ Keep track of your place on the answer sheet. If right after all. Let’s assume, for the purpose of this
you skip a question, make sure that you also skip exercise, that you are a little rusty on your signs and
the question on the answer sheet. Check yourself symptoms of a heart attack, so you need to use a little
every 5–10 questions to make sure that the num- intuition to make up for what you don’t remember.
ber of the question still corresponds with the Proceed through the answer choices in order.
number on the answer sheet.
■ Don’t rush. Though you should keep moving, ■ Start with answer a. This one is pretty easy to
rushing won’t help. Try to keep calm and work eliminate; none of these signs and symptoms is
methodically and quickly. 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,
Step 5: Learn to Use the though if you are not up on your cardiac signs
Process of Elimination and symptoms you might wonder if it should be
“acute chest pain” instead. “Sudden sweating” and
Activity: Complete worksheet on Using the Process “difficulty breathing”? Check. And that’s what
of Elimination (see page 17). you write next to answer b—a check mark, mean-
After time management, your next most important ing “good answer, I might use this one.”
tool for taking control of your exam is using the ■ Choice c is a possibility. Maybe you don’t really
process of elimination wisely. It is standard test-taking expect wheezing in a heart attack victim, but you
wisdom that you should always read all the answer know “chest pain” is right, and let’s say you are
choices before choosing your answer. This helps you not sure whether “labored breathing” is a sign of
find the right answer by eliminating wrong answer cardiac difficulty. Put a question mark next to c,
choices. And, sure enough, that standard wisdom meaning “well, maybe.”
applies to your nursing assistant exam, too. ■ Choice d is also a possibility. “Difficulty breath-
Let’s say you are facing a question that goes like ing” is a good sign of a heart attack. But wait a
this: 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- The word always in this statement makes it
tion looks like this: incorrect. Nursing assistants must also take other
measures, in addition to providing proper footwear,
Which of the following lists of signs and symp- when ambulating a resident, such as proper body
toms indicates a possible heart attack? mechanics and providing support to the client.
X a. headache, dizziness, nausea, confusion Words like usually, may, sometimes, and most may
✓ b. dull chest pain, sudden sweating, difficulty make a statement correct. Here is an example of a cor-
breathing rect statement:
? c. wheezing, labored breathing, chest pain
? d. difficulty breathing, high fever, rapid pulse Clients of healthcare facilities and hospitals may need
help with tasks such as being fed and bathed.
You have got just one check mark, for a good
answer. If you are pressed for time, you should simply The word may makes this statement correct.
mark answer b on your answer sheet. If you have got There are clients in facilities who may be too ill or weak
the time to be extra careful, you could compare your to perform daily tasks such as feeding and bathing
check mark answer to your question-mark answers to themselves.
make sure that it is better. Even when you think you are absolutely clueless
It is good to have a system for marking good, about a question, you can often use the process of
bad, and maybe answers. We recommend this one: elimination to get rid of at least one answer choice. If
so, you are better prepared to make an educated guess,
X = bad as you will see in Step 6. More often, you can eliminate
✓ = good answers until you have only two possible answers.
? = maybe Then you are in a strong position to guess.
Try using your powers of elimination on the
If you don’t like these marks, devise your own questions in the following worksheet, Using the Process
system. Just make sure you do it long before test day— of Elimination. The questions are not about healthcare
while you are working through the practice exams in work; they are just designed to show you how the
this book—so you won’t have to worry about it during process of elimination works. The answer explanations
the test. for this worksheet show one possible way you might
use the process to arrive at the right answer.
Key Words
Often, identifying key words in a question will help
you in the process of elimination. Words such as Step 6: Know When to Guess
always, never, all, only, must, and will often make state-
ments incorrect. Here is an example of an incorrect Activity: Complete worksheet on Your Guessing
statement: Ability (see page 18).
Armed with the process of elimination, you are ready
When a nursing assistant is preparing to ambulate a to take control of one of the big questions in test tak-
client, making sure the client is wearing proper ing: Should I guess? The first and main answer is Yes.
footwear will always prevent them from falling. 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. 3. Smoking tobacco has been linked to
The difference between Ed’s age and Meghan’s a. increased risk of stroke and heart attack
age is twice the difference between Ilsa’s age b. all forms of respiratory disease
and Meghan’s age. Ed is 29. How old is Ilsa? c. increasing mortality rates over the past ten
a. 4 years
b. 10 d. juvenile delinquency
c. 19
d. 24 4. Which of the following words is spelled cor-
rectly?
2. “All drivers of commercial vehicles must carry a a. incorrigible
valid commercial driver’s license whenever b. outragous
operating a commercial vehicle.” c. domestickated
According to this sentence, which of the d. understandible
following people need NOT carry a commercial
driver’s license?
a. a truck driver idling his engine while waiting
to be directed to a loading dock
b. a bus operator backing her bus out of the
way of another bus in the bus lot
c. a taxi driver driving his personal car to the
grocery store
d. a limousine driver taking the limousine to her
home after dropping off her last passenger of
the evening
Answers
Here are the answers, as well as some suggestions as to how you might have used the process of elimination to find them.
1. d. You should have eliminated answer a off the driver in choice a “operating a commercial
bat. Ilsa can’t be four years old if Meghan is vehicle”? Yes, idling counts as “operating,”
going to be Ilsa’s age in five years. The best so he needs to have a commercial driver’s
way to eliminate other answer choices is to license. Likewise, the bus operator in answer
try plugging them in to the information given b is operating a commercial vehicle; the
in the problem. For instance, for answer b, if question doesn’t say the operator has to be
Ilsa is 10, then Meghan must be 5. The differ- on the street. The limo driver in choice d is
ence in their ages is 5. The difference operating a commercial vehicle, even if it
between Ed’s age, 29, and Meghan’s age, 5, doesn’t have a passenger in it. However, the
is 24. Is 24 two times 5? No. Then answer b cabbie in answer c is not operating a com-
is wrong. You could eliminate answer c in the mercial vehicle, but his own private car.
same way and be left with answer d. 3. a. You could eliminate answer b simply because
2. c. Note the word not in the question, and go of the presence of the word all. Such
through the answers one by one. Is the truck absolutes hardly ever appear in correct
17
Using the Process of Elimination (continued)
answer choices. Choice c looks attractive two to choose from.) And choice d is plain
until you think a little about what you know— silly, so you could eliminate that one, too. You
aren’t fewer people smoking these days, are left with the correct choice, a.
rather than more? So how could smoking be 4. a. How you used the process of elimination
responsible for a higher mortality rate? (If you here depends on which words you recog-
didn’t know that mortality rate means the rate nized as being spelled incorrectly. If you
at which people die, you might keep this knew that the correct spellings were outra-
choice as a possibility, but you would still be geous, domesticated, and understandable,
able to eliminate two answers and have only then you were home free.
Your Guessing Ability
The following are ten really hard questions. You are not supposed to know the answers. Rather, this is an assessment of
your ability to guess when you don’t have a clue. Read each question carefully, 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 5. Which of the following is NOT one of the Five
a. India Classics attributed to Confucius?
b. Costa Rica a. the I Ching
c. Brazil b. the Book of Holiness
d. Australia c. the Spring and Autumn Annals
d. the Book of History
2. Which of the following is the formula for deter-
mining the momentum of an object? 6. The religious and philosophical doctrine that
a. p = MV holds that the universe is constantly in a strug-
b. F = ma gle between good and evil is known as
c. P = IV a. Pelagianism
d. E = mc2 b. Manichaeanism
c. neo-Hegelianism
3. Because of the expansion of the universe, the
d. Epicureanism
stars and other celestial bodies are all moving
away from each other. This phenomenon is 7. The third Chief Justice of the U.S. Supreme
known as Court was
a. Newton’s first law a. John Blair
b. the big bang b. William Cushing
c. gravitational collapse c. James Wilson
d. Hubble flow d. John Jay
4. American author Gertrude Stein was born in

a. 1713
b. 1830
c. 1874
d. 1901
18
Your Guessing Ability (continued)
8. Which of the following is the poisonous portion How Did You Do?
of a daffodil? You may have simply gotten lucky and actually known the
a. the bulb answer to one or two questions. In addition, your guessing
b. the leaves was probably more successful if you were able to use the
c. the stem process of elimination on any of the questions. Maybe you
d. the flowers didn’t know who the third Chief Justice was (question 7),
but you knew that John Jay was the first. In that case, you
9. The winner of the Masters golf tournament in
would have eliminated answer d and therefore improved
1953 was
your odds of guessing right from one in four to one in three.
a. Sam Snead
According to probability, you should get two and a
b. Cary Middlecoff
half answers correct, so getting either two or three right
c. Arnold Palmer
would be average. If you got four or more right, you may be
d. Ben Hogan
a really terrific guesser. If you got one or none right, you may
10. The state with the highest per capita personal be a really bad guesser.
income in 1980 was Keep in mind, though, that this is only a small sample.
a. Alaska You should continue to keep track of your guessing ability
b. Connecticut as you work through the sample questions in this book. Cir-
c. New York cle the numbers of questions you guess on as you make
d. Texas your guess; or, if you don’t have time while you take the
practice tests, go back afterward and try to remember
Answers which questions you guessed at. Remember, on a test with
Check your answers against the correct answers four answer choices, your chance of guessing correctly is
below. one in four. So keep a separate “guessing” score for each
1. c. exam. How many questions did you guess on? How many
2. a. did you get right? If the number you got right is at least one-
3. d. fourth of the number of questions you guessed on, you are
4. c. at least an average guesser—maybe better—and you
5. b. should always go ahead and guess on the real exam. If the
6. b. number you got right is significantly lower than one-fourth
7. b. of the number you guessed on, you would, frankly, be safe
8. a. in guessing anyway, but maybe you would feel more com-
9. d. fortable if you guessed only selectively, when you can elim-
10. a. 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.
19
don’t tend to work like that. The number of questions A half hour of vigorous activity—enough to raise
you answer correctly yields your raw score. So you have a sweat—every day should be your aim. If you are
nothing to lose and everything to gain by guessing. really pressed for time, every other day is OK. Choose
The more complicated answer to the question an activity you like and get out there and do it. Jogging
“Should I guess?” depends on you—your personality with a friend always makes the time go faster, or take a
and your “guessing intuition.” There are two things you portable radio or CD player.
need to know about yourself before you go into the But don’t overdo it. You don’t want to exhaust
exam: yourself. Moderation is the key.
Are you a risk-taker? Diet

Are you a good guesser? First of all, cut out the junk. Go easy on caffeine and
nicotine, and eliminate alcohol from your system at
You will have to decide about your risk-taking least two weeks before the exam. What your body
quotient on your own. To find out if you are a good needs for peak performance is simply a balanced diet.
guesser, complete the worksheet, Your Guessing Ability Eat plenty of fruits and vegetables, along with protein
on page 18. and carbohydrates. Foods that are high in lecithin (an
amino acid), such as fish and beans, are especially good
“brain foods.”
Step 7: Reach Your Peak The night before the exam, you might “carbo-
Performance Zone load” the way athletes do before a contest. Eat a big
plate of spaghetti, rice and beans, or whatever your
Activity: Complete the Physical Preparation Check- favorite carbohydrate is.
list.
To get ready for a challenge like a big exam, you have Rest
to take control of your physical, as well as your men- You probably know how much sleep you need every
tal, state. Exercise, proper diet, and rest in the weeks night to be at your best, even if you don’t always get it.
prior to the test will ensure that your body works with, Make sure you do get that much sleep, though, for at
rather than against, your mind on test day, as well as least a week before the exam. Moderation is important
during your preparation. here, too. Extra sleep will just make you groggy.
If you are not a morning person and your exam
Exercise will be given in the morning, you should reset your
If you don’t already have a regular exercise program internal clock so that your body doesn’t think you are
going, the time during which you are preparing for an taking an exam at 3 A.M. You have to start this process
exam is actually an excellent time to start one. And if well before the exam. The way it works is to get up half
you are already keeping fit—or trying to get that an hour earlier each morning, and then go to bed half
way—don’t let the pressure of preparing for an exam an hour earlier that night. Don’t try it the other way
fool you into quitting now. Exercise helps reduce stress around; you will just toss and turn if you go to bed
by pumping feel-good hormones, called endorphins, early without having gotten up early. The next morn-
into your system. It also increases the oxygen supply ing, get up another half an hour earlier, and so on.
throughout your body, including your brain, so you How long you will have to do this depends on how late
will be at peak performance on test day. you are used to getting up.
20
Step 8: Get Your Act Together Don’t Skip Breakfast

Even if you don’t usually eat breakfast, do so on exam
Activity: Complete Final Preparations worksheet. morning. A cup of coffee doesn’t count. Don’t eat
You are in control of your mind and body; you are in doughnuts or other sweet foods, either. A sugar high
charge of test anxiety, your preparation, and your test- will leave you with a sugar low in the middle of the
taking strategies. Now it is time to take charge of exter- exam. A mix of protein and carbohydrates is best:
nal factors, like the testing site and the materials you cereal with milk and just a little sugar, or eggs with
need to take the exam. toast, will do your body a world of good.
Find Out Where the Test Is and

Make a Trial Run Step 9: Do It!
The testing agency or your nursing assistant instructor
will notify you when and where your exam is being Activity: Ace the nursing assistant exam!
held. Do you know how to get to the testing site? Do Fast forward to exam day. You are ready. You made a
you know how long it will take to get there? If not, study plan and followed through. You practiced your
make a trial run, preferably on the same day of the test-taking strategies while working through this
week at the same time of day. Make note, on the work- book. You are in control of your physical, mental, and
sheet Final Preparations on page 22, of the amount of emotional states. You know when and where to show
time it will take you to get to the exam site. Plan on up and what to bring with you. In other words, you are
arriving at least 10–15 minutes early so you can get the better prepared than most of the other people taking
lay of the land, use the bathroom, and calm down. the nursing assistant exam with you. You are psyched.
Then figure out how early you will have to get up that Just one more thing. . . . When you are done with
morning, and make sure you get up that early every the exam, you deserve a reward. Plan a celebration.
day for a week before the exam. Call up your friends and plan a party, or have a nice
dinner for two—whatever your heart desires. Give
Gather Your Materials yourself something to look forward to.
The night before the exam, lay out the clothes you will And then do it. Go into the exam, full of confi-
wear and the materials you have to bring with you to dence, armed with test-taking strategies you have prac-
the exam. Plan on dressing in layers; you won’t have ticed until they are second nature. You are in control of
any control over the temperature of the examination yourself, your environment, and your performance on
room. Have a sweater or jacket you can take off if it is the exam. You are ready to succeed. So do it. Go in
warm. Use the checklist on the worksheet Final Prep- there and ace the exam. And look forward to your
arations on the following page to help you pull future career as a nursing assistant!
together what you will need.
21
Final Preparations
Getting to the Exam Site
Location of exam site:
Date:
Departure time:
Do I know how to get to the exam site? Yes No (If no, make a trial run.)
Time it will take to get to exam site:
Things to Lay Out the Night Before
Clothes I will wear
Sweater/jacket
Watch
Photo ID
Four #2 pencils
Other Things to Bring/Remember
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.
Time Preparation Time Preparation
Days 1–3 Skim over the written materials from Day 17 Take the third practice exam.
your training program, particularly Day 18 Once again, identify one area to review,
noting any areas you expect to be based on your score on the third prac-
emphasized on the exam or any areas tice exam.
you don’t remember well.
Days 19–20 Study the one area you identified for
Day 4 Take the first practice exam in Chap- review.
ter 3.
Days 21–23 Take an overview of all your training
Day 5 Score the first practice exam. Based on materials, consolidating your strengths
this exam, identify your strongest and and improving on your weaknesses.
weakest areas. Pick two areas that you
Days 24–25 Review all the areas that have given you
will concentrate on before you take the
the most trouble in the three practice
second practice exam.
exams you have taken so far.
Days 6–8 Study the two areas you identified as
Day 26 Take the fourth practice exam in Chap-
your weak points. Don’t worry about
ter 6. Note how much you have
the other areas.
improved!
Days 9–10 Take the second practice exam in
Days 27–28 Review any areas in which you still feel
Chapter 4.
unsure.
Day 11 Score the second practice exam. Iden-
Day 29 Take the final practice exam.
tify one area to concentrate on before
Day before Relax. Do something unrelated to the
you take the third practice exam.
the exam exam and go to bed at a reasonable
Days 12–16 Study the one area you identified for
hour.
review. In addition, review both prac-
tice exams you have taken so far, with
special attention to the answer explana-
tions.
23
Schedule B: The 10-Day Plan
If you have two weeks or less before you take the exam, you may have your work cut out for you. Use this 10-day
schedule to help you make the most of your time.
Time Preparation Time Preparation
Day 1 Take the first practice exam in Chapter Day 6 Take the third practice exam in Chapter
3 and score it using the answer key at 5 and score it.
the end. Identify which skill areas need Day 7 Choose your weakest area from the
the most work, based on your exam third practice exam to review.
score.
Day 8 Review any areas that you have not yet
Day 2 Review one area that gave you trouble reviewed in this schedule.
on the first practice exam.
Day 9 Take the fourth practice exam in Chap-
Day 3 Review another area that gave you ter 6 and score it.
trouble on the first practice exam.
Day 10 Use your last study day to brush up on
Day 4 Take the second practice exam in any areas that are still giving you trou-
Chapter 4 and score it. ble and then take the fifth practice
Day 5 If your score on the second practice exam.
exam doesn’t show improvement on Day before Relax. Do something unrelated to the
the two areas you studied, review them. the exam exam and go to bed at a reasonable
If you did improve in those areas, hour.
choose a new weak area to study today.
24
C H A P T E R
Nursing
3 Assistant/Nurse
Aide Practice
Exam 1
CHAPTER SUMMARY
This is the first of five practice exams in this book based on the
National Nurse Aide Assessment Program (NNAAP) written exam. Use
this first test to identify your areas of strength and weakness.
I■
F YO U A R Erequired 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
25
– NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1 –
next page. After the exam is an answer key, with all the to Appendix A for a breakdown of the question types.
answers explained. These explanations will help you The chart will help you understand which kinds of
see your areas of strength and weakness. Then you will questions are most difficult for you so you can focus
know which parts of your training materials to study on those skills for next time. Generally, a score of 75%
before you take the second practice exam. You can refer or more is considered passing.
26
– NURSING ASSISTANT/NURSE AIDE ANSWER SHEET –
Practice Pretest
1. a b c d 5. a b c d 9. a b c d
2. a b c d 6. a b c d 10. a b c d
3. a b c d 7. a b c d
4. a b c d 8. a b c d
Exam 1
1. a b c d 21. a b c d 41. a b c d
2. a b c d 22. a b c d 42. a b c d
3. a b c d 23. a b c d 43. a b c d
4. a b c d 24. a b c d 44. a b c d
5. a b c d 25. a b c d 45. a b c d
6. a b c d 26. a b c d 46. a b c d
7. a b c d 27. a b c d 47. a b c d
8. a b c d 28. a b c d 48. a b c d
9. a b c d 29. a b c d 49. a b c d
10. a b c d 30. a b c d 50. a b c d
11. a b c d 31. a b c d 51. a b c d
12. a b c d 32. a b c d 52. a b c d
13. a b c d 33. a b c d 53. a b c d
14. a b c d 34. a b c d 54. a b c d
15. a b c d 35. a b c d 55. a b c d
16. a b c d 36. a b c d 56. a b c d
17. a b c d 37. a b c d 57. a b c d
18. a b c d 38. a b c d 58. a b c d
19. a b c d 39. a b c d 59. a b c d
20. a b c d 40. a b c d 60. a b c d
27
6. The proper medical abbreviation for before

Pretest Practice meals is
a. p.c.
1. When assisting a client in learning to use a b. b.i.d.
walker, it is important to c. a.c.
a. stand behind him and use a transfer belt. d. t.i.d.
b. put padding all the way around the top rim.
c. let him walk by himself so he gains independ- 7. The proper medical term for high blood pres-
ence. sure is
d. let him practice using the walker on the day a. diabetes.
he is discharged. b. hypertension.
c. hypotension.
2. Urinary retention refers to d. CVA.
a. normal output of urine.
b. inability to urinate. 8. A patient who has difficulty chewing or swallow-
c. incontinence. ing will need what type of diet?
d. large output of urine. a. clear liquid
b. low residue
3. Normal hearing loss in aging is usually related to c. bland
the ability to hear d. mechanical soft
a. high-pitched sounds.
b. loud sounds. 9. When shaving a male patient’s face, it is impor-
c. all sounds. tant to
d. rapid speech. a. apply shaving cream sparingly.
b. use upward strokes when shaving the cheeks.
4. The best way to safely identify your patient is by c. apply Betadine to any nicks.
a. asking his name. d. none of the above
b. calling his name and waiting for his response.
c. checking the bed plate. 10. How often should a patient’s intake and output
d. checking the name tag. records be totaled?
a. once each shift
5. OSHA rules specify that, when washing out b. twice a day
soiled linens, the following must be worn c. every 4 hours
a. gloves d. every 12 hours
b. goggles
c. gloves and goggles
d. gloves, goggles, and apron
29
Exam 1 5. When assisting a client in and out of bed, the

nurse aide should always
1. Which of the following should you observe and a. employ body mechanic techniques.
record when admitting a client? b. get another person to help.
a. color of the stool and amount of urine voided c. pull the client’s feet out first, and then lift the
b. how much the client has eaten and drunk back up.
c. bruises, marks, rashes, or broken skin d. put shoes on the client because the patient
d. insurance information may slip.
2. When responding to a client on the intercom, 6. When should you wash your hands?
you should a. when you notice they look or feel dirty
a. ask for the client’s name. b. when the charge nurse tells you to
b. say, “What do you want?” c. at least twice a day
c. give your name and position and say “may I d. before and after contact with a patient
help you?”
d. say, “The nurse will answer your call.” 7. Which of the following is the correct procedure
for serving a meal to a client who must be fed?
3. Which of the following things should you do to a. serve the tray along with all the other trays,
familiarize a new client with his or her surround- and then come back to feed the client
ings? b. bring the tray to the client last; feed after you
a. Show the client where the call light is and how have served all the other clients
to work it. c. bring the tray into the room when you are
b. Tell the client not to operate the TV. ready to feed the client
c. Ask visitors to leave the room while you finish d. have the kitchen hold the tray for one hour
admitting the client.
d. Raise the side rails of the bed and raise the 8. The MOST serious problem that wrinkles in the
bed to high position. bedclothes can cause is
a. restlessness.
4. When arranging a patient’s room, you should do b. sleeplessness.
all of the following EXCEPT c. decubitus ulcers.
a. check signal cords. d. bleeding and shock.
b. adjust the back and knee rests as directed.
c. administer medications. 9. An important way to reduce the incidence of
d. check lighting. 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. 15. When cleaning a client’s dentures at the sink, the
Before changing the position of the client’s bed, reason to either line the emesis basin with a
you should paper towel or to fill the sink with water is to
a. open the window. a. prevent contamination of the dentures.
b. explain the procedure to the client. b. hide the dentures from view.
c. check with the client’s family. c. guard against breaking the dentures.
d. remake the bed. d. protect the basin from scratches.
11. During hand washing, the nurse aide acciden- 16. When assisting a client with eating, one of the
tally touches the inside of the sink while rinsing FIRST things the nurse aide should do is
the soap off. The NEXT action is to a. cut the food into large bite-size pieces.
a. allow the water to run over the hands for two b. wash his/her hands and the client’s hands.
minutes. c. butter the client’s bread.
b. dry the hands and turn off the faucet with the d. provide the client with privacy.
paper towel.
c. repeat the wash from the beginning. 17. A patient has a new cast on his right arm. While
d. none of the above caring for him, it is important to FIRST observe
for
12. When giving mouth care to an unconscious a. pulse above the cast.
patient, the safest position to prevent aspira- b. color and hardness of the cast.
tion is c. warmth and color of fingers.
a. on her or his back. d. signs of crumbling at the cast end.
b. in semi-Fowler’s position.
c. with the head turned to the side. 18. Encouraging a client to take part in activities of
d. in the supine position. daily living (ADLs) such as bathing, combing
hair, and feeding is
13. Mr. Roark, a newly admitted conscious client, a. done only when time permits.
has been put to bed. Before leaving him alone, b. the family’s responsibility.
the FIRST action would be to c. necessary for rehabilitation.
a. ask him if he is hungry. d. a violation of client rights.
b. inspect his skin.
c. complete the listing of his clothing and valu- 19. In caring for a confused elderly man, it is impor-
ables. tant to remember to
d. make sure he knows how to use the call light. a. keep the bedrails up except when you are at
the bedside.
14. When lifting a heavy object, the correct method b. close the door to the room so that he does not
would be to bend at the disturb other patients.
a. waist, keeping your legs straight. c. keep the room dark and quiet at all times to
b. waist, rounding your shoulders. keep the patient from becoming upset.
c. knees, keeping your back straight. d. remind him each morning to shower and
d. knees and waist. shave independently.
31
20. Before assisting a client into a wheelchair, the 25. Mrs. Black is a diabetic. For her midafternoon
FIRST action would be to check if the nourishment, the kitchen has sent a carton of
a. client is adequately covered. chocolate ice cream. Your FIRST action should
b. floor is slippery. be to
c. door to the room is closed. a. substitute diet cola for ice cream.
d. wheels of the chair are locked. b. hold the nourishment and report to the
charge nurse.
21. While giving an unconscious patient a bath, it is c. ask the secretary to notify the kitchen of an
important to error.
a. give passive range of motion to all joints. d. ask Mrs. Black if she likes ice cream.
b. let the charge nurse exercise the patient’s
joints. 26. When assisting a client to use the bedside com-
c. call the physical therapist to exercise the mode, it is important to
patient afterwards. a. leave the call light within reach.
d. exercise the patient only if the doctor has b. place toilet tissue close by.
ordered it. c. return to check on the client periodically.
d. all of the above
22. You are assigned to assist Mrs. Kelley with her
lunch. She is on bed rest. The BEST position for 27. When assisting Mr. Byrd, a blind client, with his
her, if permitted, would be meal, it is NECESSARY to
a. Tredelenberg position. a. sit next to him to help.
b. hyperextension. b. identify each item on his tray.
c. legs dangling at the side of the bed. c. feed him so he won’t spill his food.
d. Fowler’s position. d. insist that he use only a spoon.
23. When moving a wheelchair onto an elevator, you 28. The purpose of cold applications is usually to
should stay a. speed the flow of blood to the area.
a. behind the chair, pulling it toward you. b. prevent heat exhaustion.
b. behind the chair, pushing it away from you. c. prevent or reduce swelling.
c. in front of client to observe his or her condi- d. prevent the formation of scar tissue.
tion.
d. to the side and hold the door open. 29. The hot water bottle is an example of a
a. local dry heat application.
24. The Foley bag must be kept lower than the b. generalized dry heat application.
client’s bladder so that c. local moist heat application.
a. urine will not leak out, soiling the bed. d. generalized moist heat application.
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.
32
30. Clients receiving an enema are usually placed 35. When giving information to the charge nurse for
a. on the right side. an incident report, the nurse aide should
b. on the left side. a. write in the client’s chart that an incident
c. flat on the back. occurred.
d. in a semisitting position. b. keep the report in your personal file.
c. state the facts clearly.
31. A female client’s perineal area should be cleansed d. give your opinions as to the cause of the inci-
before which specimen is collected? dent.
a. 24-hour urine specimen
b. midstream clean-catch urine specimen 36. All long-term-care nurse aides must be compe-
c. pediatric routine urine specimen tency evaluated and must complete a distinct
d. routine urine specimen educational course. These requirements are
set by
32. The most common site for counting the pulse is a. OBRA.
the b. OSHA.
a. carotid artery. c. CDC.
b. femoral artery. d. FDA.
c. brachial artery.
d. radial artery. 37. Sexuality changes in aging can result in
a. decreased sexual desire.
33. When counting respirations, the nurse aide b. unchanged sexual desire.
should c. increased sexual desire.
a. wait until after the client has exercised. d. all of the above
b. not tell the patient what you are going to do.
c. count five respirations and then check your 38. When family members visit a client, the visitors
watch. should
d. have the client count respirations while you a. stay in the day room.
take her pulse. b. stay a short while so as not to tire the client.
c. be expected to help with care.
34. With catheterized patients, which of the follow- d. be allowed privacy with the client.
ing is NOT the nurse aide’s responsibility?
a. insertion of catheter 39. You may attend resident council meetings in an
b. prevention of infection eldercare facility (ECF) if
c. checking to make sure the catheter is draining a. you are invited to attend.
properly b. your superior assigns you to attend.
d. recording output c. you are interested in what the residents are
discussing.
d. none of the above
33
40. Which of the following is considered a client’s 45. A goal for an ECF resident is that she not swear
right? at the nurses or aides. When she calls you by
a. having curtains pulled during personal care your name, your appropriate action is to
b. having personal information kept confidential a. smile and give the appropriate reward.
c. receiving and sending private mail b. continue whatever task that is being done.
d. all of the above c. tease the resident about not swearing.
d. tell all of the staff that she didn’t swear.
41. An ECF resident wishes to wash her own under-
wear. You should 46. An agitated resident must be turned every two
a. ignore the request. hours all night long. The first action of the nurse
b. tell her that clothing must go to the laundry. aide when waking up this resident is to
c. tell her you will do it. a. turn on the light.
d. help her obtain supplies. b. speak quietly and calmly.
c. touch her shoulder.
42. In the long-term-care facility, the family mem- d. shout her name.
bers should be asked to
a. leave during treatments. 47. If a client objects to certain food for religious or
b. attend care-planning meetings. cultural reasons, the appropriate action would
c. avoid visiting during mealtimes. be to
d. help perform client care. a. tell him to wait for the next meal.
b. offer to substitute something different for
43. Sexuality in long-term-care clients may include him.
all of the following except c. call the dietician on the next day.
a. needing private time with a partner. d. tell him he needs to eat what is on his tray.
b. caring about one’s physical appearance.
c. engaging in public fondling. 48. The client’s religion forbids eating pork. Bacon is
d. desiring sexual interaction. being served for breakfast. The MOST appropri-
ate response is to
44. Which statement about some patients with a. encourage the client to eat it because she
developmental disabilities is correct? needs protein.
a. They usually have no ADL skills. b. tell the client it is all right since her doctor
b. They are usually bed bound. ordered the diet.
c. They can learn, but at a slow pace. c. call the kitchen for a tray without bacon.
d. They are dangerous because they are always d. tell the client that restrictions don’t pertain in
strong. times of illness.
34
– NURSING ASSISTANT/NURSE
– CHAPTER TITLE
AIDE –PRACTICE EXAM 1 –
49. If a client asks a question you cannot answer, the 54. A patient turns on the call light when he needs to
best response is to urinate. The appropriate action is to
a. tell the client you will ask another aide. a. ignore the light since he is not your client.
b. ask the charge nurse to talk to the client. b. announce on the intercom that there are two
c. call the doctor to talk to the client. patients ahead of him.
d. tell the client that you cannot answer the c. answer the call light and get the urinal.
question. d. answer the call light when you have the time.
50. Before bathing a client, the nursing assistant 55. A prosthesis is

should a. an artificial substitute for a missing body part.
a. close the door and pull the curtain. b. a device for moving patients.
b. gather a change of clothing. c. an expected condition of the aging process.
c. check for a doctor’s order. d. a disease of the circulatory system.
d. all of the above
56. When performing catheter care, the nurse aide
51. On entering a room, you notice that the client is should wash the catheter
not breathing. Your FIRST action should be to a. toward the meatus.
a. call for help. b. with Betadine soap.
b. lay the client down on his back. c. away from the meatus.
c. give four quick breaths. d. with alcohol.
d. give 8–10 abdominal thrusts.
57. A nurse aide who applies restraints on a client
52. A client’s dentures are lost. The first action without directions from the charge nurse may be
would be to accused of
a. notify the administrator. a. slander.
b. look for them. b. battery.
c. notify the doctor. c. false imprisonment.
d. notify the charge nurse. d. negligence.
53. As a nurse aide, it is your responsibility to 58. H.S. care is care that is given
a. plan the client’s care. a. before meals.
b. do the tasks the supervisor assigns to you. b. before bedtime.
c. do the best you can without asking for help. c. after meals.
d. compare assignments with your coworkers. d. upon awakening.
35
59. The BEST food choices for a geriatric client with 60. The family wants to talk about Bill’s approaching
no teeth would include death, but Bill does not. The family should be
a. hamburger, french fries, corn, and ice cream. encouraged to
b. baked chicken, dressing, green beans, and a. carry on the conversation away from Bill.
coconut macaroons. b. talk freely in the room regardless of Bill’s
c. spare ribs, macaroni and cheese, coleslaw, and wishes.
fruit cocktail. c. wait until Bill dies.
d. baked fish, whipped potatoes, spinach soufflé, d. try to encourage Bill to take part in the con-
and tapioca. versation.
36
Answers and Explanations
Pretest Practice 5. a. You should always use good body mechanics

1. a. Standing behind him and using a transfer belt when moving patients.
protects both the client and the aide.
6. d. You should wash your hands before and after
2. b. Retention of urine is a symptom that should contact with a patient.
be reported to the charge nurse as soon as it is
7. c. You should not bring the tray into the room
noted.
until you have time to feed.
3. a. Because of this aspect of hearing loss, the aged
8. c. The most serious problem that wrinkles in the
hear better if you lower your voice. Shouting
bedclothes can cause patients are decubitus
in a high-pitched voice does not help.
ulcers, or decubiti.
4. d. A confused patient may answer to any name
9. c. Changing the patient’s position every two
or lie down in any bed.
hours prevents bedsores.
5. c. To protect yourself, you must wear gloves and
10. b. You should always explain procedures first, so
goggles.
b is the correct answer.
6. c. The proper medical abbreviation for before
11. c. You have contaminated your hands and must
meals is a.c.
start over.
7. b. The proper medical term for high blood pres-
12. c. Turning the head to the side will assist in
sure is hypertension.
drainage out of the mouth.
8. d. A mechanical soft diet is easy to chew, swal-
13. d. Always make sure new patients can call for
low, and digest.
help.
9. d. All of the answers a–c are wrong.
14. c. Keeping your back straight forces you to use
10. a. Input and output are totaled once per shift as your strong leg muscles.
well as every 24 hours.
15. c. The purpose of this procedure is to prevent
breakage.
Exam 1
1. c. Failure to notice bruises or marks on the skin 16. b. Always remember to consider infection con-
on admission may later cause someone to trol.
believe you were involved in abuse.
17. c. A new cast may cut off circulation. Choice c
2. c. When responding to a patient on the inter- reminds you to check for circulatory impair-
com, you should give your name and position. ment.
3. a. You should never leave a new admit until the 18. c. Rehabilitation should always be part of the
patient knows how to call for help. care plan.
4. c. Nursing assistants are never allowed to give 19. a. Make sure to follow agency policy.
medications.
37
20. d. Before assisting a patient into a wheelchair, 35. c. An incident report becomes a permanent part
check to see if the wheels of the chair are of the legal record. Make sure the facts are
locked. clear.
21. a. Passive ROM should always be given with the 36. a. OBRA stands for the Omnibus Budget and
bath on an unconscious patient. Reform Act.
22. d. Semi-Fowler’s position is correct because the 37. d. Sexual desire is related to emotions as well as
patient is on bed rest. physical ability, so all the answers listed may
be correct for different individuals.
23. a. You must stay behind the chair to control it,
but it should go on and come off an elevator 38. d. The family members should expect and be
backwards to prevent the wheels from falling allowed private time with their loved one.
into the door opening.
39. a. The resident council is a meeting of the resi-
24. b. Raising the bag above the bladder level can dents, and no staff may attend unless invited.
lead to backflow of the urine, with its bacteria,
40. d. All of the answers given are rights of the resi-
into the bladder.
dent.
25. b. Always report abnormal conditions.
41. d. The patient has the right to wash her own
26. d. All of the answers listed are correct. clothes if she so wishes. You must help her to
do so.
27. b. A blind patient should know what you are giv-
ing him before it enters his mouth. 42. b. Federal law states that residents have the right
to have family involvement in care planning.
28. c. The purpose of cold applications is usually to
prevent or reduce swelling. 43. c. As long-term-care providers, nursing assis-
tants must respect the resident’s right to sexu-
29. a. A hot water bottle applied by itself is dry heat.
ality. However, engaging in public fondling is
30. b. Placing the patient on the left side allows bet- inappropriate and may infringe on other resi-
ter entry into the colon. dents’ rights.
31. b. The clean-catch specimen requires cleaning 44. c. Patients with mental retardation are all differ-
the perineum. ent. The important thing to remember is that
many of them can learn; those who can just
32. d. The other sites are rarely used by the nursing
do so more slowly than other people.
assistant.
45. a. You want to positively reinforce the resident’s
33. b. Telling the patient you are watching her
appropriate behavior, so smiling and reward-
breathing will cause her to slightly change her
ing her good behavior is the best action.
breathing pattern.
46. b. Do not startle the resident, as this may agitate
34. a. A nursing assistant is responsible for the other
her. Speak as you enter the room.
options but never inserts a catheter.
47. b. Consideration of cultural or religious beliefs is
important to all patients.
38
48. c. The other answers do not address the resi- 54. c. Answer any call light as soon as possible.
dent’s right to practice their religion.
55. a. Examples of prostheses include artificial
49. b. Always refer such questions to the charge limbs, hearing aids, and dentures.
nurse to handle.
56. c. You should follow the clean-to-dirty princi-
50. a. Choice b is incorrect because some residents ple, with the meatus considered cleaner than
are capable of choosing their own clothing. the catheter tubing.
Choice c is incorrect because there will not be
57. c. Applying restraints without an order/without
a doctor’s order for a bath. Choice d, there-
consent can be considered false imprison-
fore, is also incorrect.
ment.
51. a. Always call for help first in an emergency.
58. b. H.S. is the abbreviation for hour of sleep.
52. d. The first step for any lost belongings is always
59. d. Of the choices listed, only d is a soft diet.
to notify the charge nurse.
60. a. Involve Bill if he chooses, but have the family
53. b. Choice a is incorrect because you are a mem-
talk privately otherwise.
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.
39
C H A P T E R
Nursing
4 Assistant/Nurse
Aide Practice
Exam 2
CHAPTER SUMMARY
This 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.
L IKE THE FIRST 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.
41
Pretest Practice
1. a b c d 5. a b c d 9. a b c d
2. a b c d 6. a b c d 10. a b c d
3. a b c d 7. a b c d
4. a b c d 8. a b c d
Exam 2
1. a b c d 21. a b c d 41. a b c d
2. a b c d 22. a b c d 42. a b c d
3. a b c d 23. a b c d 43. a b c d
4. a b c d 24. a b c d 44. a b c d
5. a b c d 25. a b c d 45. a b c d
6. a b c d 26. a b c d 46. a b c d
7. a b c d 27. a b c d 47. a b c d
8. a b c d 28. a b c d 48. a b c d
9. a b c d 29. a b c d 49. a b c d
10. a b c d 30. a b c d 50. a b c d
11. a b c d 31. a b c d 51. a b c d
12. a b c d 32. a b c d 52. a b c d
13. a b c d 33. a b c d 53. a b c d
14. a b c d 34. a b c d 54. a b c d
15. a b c d 35. a b c d 55. a b c d
16. a b c d 36. a b c d 56. a b c d
17. a b c d 37. a b c d 57. a b c d
18. a b c d 38. a b c d 58. a b c d
19. a b c d 39. a b c d 59. a b c d
20. a b c d 40. a b c d 60. a b c d
43
6. The purpose of correctly positioning the client

Pretest Practice is to
a. prevent skin breakdown.
1. Decubitus ulcers may develop in clients who are b. maintain function of joints and muscles.
a. incontinent. c. increase comfort.
b. paralyzed. d. all of the above
c. poorly nourished.
d. all of the above 7. Which of the following statements about dress-
ing ECF residents is true?
2. A walker may be used if the client can a. It is not necessary for handicapped residents
a. support some weight. to dress in street clothes.
b. use her hands well. b. Residents like staff members to dress them.
c. balance without help. c. Residents are concerned about how they look.
d. walk independently. d. Residents are used to being dressed in front of
others.
3. A cane should be used on
a. the affected (weak) side of the body. 8. The preferred way to remove a bedpan from a
b. the unaffected (strong) side of the body. client who is unable to lift her buttocks is to
c. the side with the strongest arm. a. use a mechanical lifting device.
d. the weak side one day, strong side next day. b. have another nursing assistant lift the client.
c. turn the client to the side while holding the
4. Which of the following statements about ROM is pan.
FALSE? d. slowly slide the pan from under the client.
a. Active ROM means the client does the exer-
cises. 9. At the beginning of your shift, you give a client a
b. Passive ROM means the nursing assistant does water pitcher containing 270 cc (9 oz.) of water.
the exercises. At the end of your shift, you note that 35 cc of
c. Active ROM means the resident does the water is left in the pitcher. How much water has
exercises. been consumed?
d. Active ROM is best, if possible. a. 35 cc
b. 135 cc
5. When helping a client use a walker, it is impor- c. 175 cc
tant to tell him to d. 235 cc
a. move the walker and his feet at the same time.
b. move the walker, place the walker firmly, and 10. When a client complains that his dentures are
step. hurting, the appropriate action is to
c. move the walker and then slide his feet. a. encourage him to wear the dentures more
d. take several steps, slide the walker, and then often.
place the walker firmly. b. report the complaint to the charge nurse.
c. report the complaint to the physician.
d. put the dentures on the bedside table.
45
6. The patient’s TPR is 98.8-80-30. The finding that

Exam 2 should be reported at once is
a. pulse.
1. A water pitcher has tipped over and you notice b. temperature.
water on the floor. The BEST action is to c. respiration.
a. wipe it up immediately. d. all of the above
b. throw a towel over the water to prevent acci-
dents. 7. Which of the following can cause an inaccurate
c. notify the charge nurse. oral temperature reading?
d. call housekeeping. a. drinking hot or cold liquids within ten min-
utes of the reading
2. On entering a room, you notice that the patient b. failure to shake down a mercury thermometer
is not breathing. Your FIRST action should be to c. vigorous exercise prior to measuring tem-
a. call for help. perature
b. lay the resident down on his back. d. all of the above
c. give four quick breaths.
d. give 8–10 abdominal thrusts. 8. Systolic blood pressure is determined by
a. reviewing previous readings.
3. When making an occupied bed, it is impor- b. listening for the first clear sound.
tant to c. waiting for a change in sound.
a. make half of the bed at one time. d. listening for the last clear sound.
b. have one side rail up and one down.
c. make a toe pleat in the top covers. 9. The order “weigh client q.o.d.” means to weigh
d. all of the above the client every
a. other week.
4. Decubitus ulcers can be prevented by b. other day.
a. changing the client’s position frequently. c. morning.
b. placing an egg-crate mattress on top of the d. week.
mattress.
c. increasing the patient’s vitamin C consump- 10. The FIRST step in performing any procedure
tion. is to
d. both a and b a. explain the procedure.
b. gather needed equipment.
5. The first step in getting a client up to walk is to c. wash your hands.
a. sit the client on the side of the bed. d. provide privacy.
b. put the client’s slippers on.
c. check the activity order.
d. tell the client what you want him to do.
46
11. Which of the following procedures best destroys 16. If a client cannot speak English, the nurse aide
all bacteria? should
a. soaking in alcohol a. have the family interpret.
b. washing with bleach b. ask the charge nurse to arrange for an inter-
c. sterilizing preter.
d. all of the above c. call the doctor to talk to the client.
d. tell the client that you cannot answer the
12. In the event of a fire in a client’s room, your question.
FIRST action should be to
a. notify the charge nurse. 17. The accepted way to identify a client is to
b. turn in a fire alarm. a. check the bed name and number.
c. get the client to a safe place. b. check the identification band.
d. get the fire extinguisher. c. ask the client’s name.
d. call the client by name.
13. Safe use of oxygen therapy includes
a. always setting the flow meter at 2–3 liters per 18. Which of the following best describes nail care?
minute. a. Nail care is not needed for the elderly.
b. using wool blankets only. b. Use scissors for all nail care.
c. cleansing the nasal prongs each shift with c. All clients need nail care.
alcohol. d. Check with the charge nurse for nail-care
d. posting a “no smoking” sign on the door. instructions.
14. When you perform CPR, the client should be 19. When performing perineal care on a male,
lying always
a. flat on a hard surface. a. clean the scrotum first.
b. with head and shoulders elevated. b. retract the foreskin if uncircumcised.
c. with the head and feet raised slightly. c. clean from front to back.
d. none of the above d. hold the penis at a 90-degree angle.
15. A procedure manual is a 20. The reasons for rubbing a client’s back include
a. written set of instructions on how to perform a. improving circulation.
procedures. b. increasing one-on-one interaction time.
b. set of directions needed to complete your job c. relaxing the client.
description. d. all of the above
c. book of directions for administering medica-
tions. 21. The client’s elbows are dry and red. You should
d. book listing the procedures you have been a. report this to the charge nurse.
assigned to do. b. rub them with lotion.
c. apply elbow protectors.
d. all of the above
47
22. A decubitus ulcer is caused by 28. Before transferring a client from the bed to a
a. poor circulation. wheelchair, the nurse aide should sit him or her
b. pressure on the skin. on the edge of the bed for a few minutes to
c. poor nutrition. a. rearrange his or her gown or clothing.
d. all of the above b. prevent orthostatic hypotension.
c. position and secure the wheelchair.
23. You would shampoo a client’s hair to improve d. rest and remove the transfer belt.
a. circulation to the scalp.
b. the client’s general appearance. 29. The client’s religion forbids eating meat. Beef
c. the client’s feeling of well-being. stew is being served for lunch. The nurse aide
d. all of the above should
a. tell the client to eat it because she needs pro-
24. When removing a soiled gown from a client who tein.
has an IV, the BEST action is to b. tell the client it is all right since her doctor
a. remove the opposite arm from the gown first. ordered the diet.
b. have the nurse remove the IV needle. c. ask the nurse to call the kitchen.
c. disconnect the bag and tubing. d. tell the client that restrictions don’t pertain in
d. slip the gown over the IV solution bag. times of illness.
25. If your client does not eat all the food on his tray, 30. It is important to remember that dying patients
the FIRST thing you should do is a. have the same needs for care as other patients.
a. notify the charge nurse. b. need to be by themselves in a quiet room.
b. ask the client why. c. do not need to be consulted regarding their
c. remove the tray. care.
d. urge the client to eat all the food. d. are usually in pain.
26. The client states that a mistake has been made: 31. Dying patients and their families
There is salt on her tray, although the doctor has a. always pass through five stages of dying in
ordered a low-salt diet. The nurse aide should order.
a. explain this means no salt when preparing b. always accept death before it occurs.
food. c. may go back and forth among the five stages.
b. tell the client not to use the salt. d. must go through all stages of dying before
c. check the diet order with the charge nurse. they die.
d. call the kitchen for a new tray.
32. A sign of dementia in elderly clients is
27. The MAIN safety factor in transferring a client a. a need to eat regular meals.
is to b. not knowing who and where they are.
a. always transfer slowly. c. an ability to figure out problems.
b. raise the side rails. d. a good memory for recent events.
c. secure adequate assistance.
d. make sure the client is not tired.
48
33. Clients with Alzheimer’s disease may show which 39. The nurse aide must report abuse of a client by
of the following signs/symptoms? a. the family.
a. physical and mental wasting away b. the staff.
b. extremely clear memory c. another client.
c. frequent pacing or wandering d. all of the above
d. a and c only
40. If the client is in traction, the nurse aide should
34. When a client turns on the call light every few never
minutes, the appropriate response is to a. monitor affected skin temperature.
a. ask the client not to call so often. b. give a total bed bath.
b. stop by the room more often. c. change the position of weights.
c. place the call light out of reach. d. monitor distal pulses.
d. tell the client how busy you are.
41. Security for a client’s dentures includes
35. Many older adults suffer loss of a. keeping them in a tissue in a dresser drawer.
a. income. b. placing them in a labeled denture cup.
b. physical strength. c. insisting the resident wear the dentures.
c. loved ones. d. placing an identifying mark on the dentures.
d. all of the above
42. If family members bring new clothes in for an
36. How a client reacts to illness and disability is ECF resident, the nurse aide should
MOST dependent on his or her a. put them in the resident’s dresser drawers.
a. age and stage of life. b. label them with the resident’s name.
b. spouse’s support. c. ask the family to remove an equal number of
c. income and level of education. old clothes.
d. support system and life history. d. make sure the charge nurse sees the clothes.
37. An 85-year-old client tells you that his mother is 43. The charge nurse instructs you to clean an ECF
coming to visit. Your BEST response would be resident’s closet. You should
a. “That’s impossible. Your mother can’t come to a. throw away all torn clothes.
see you.” b. ask the family to come do it.
b. “That’s nice, when is she coming?” c. enlist the help of the resident.
c. “Tell me how old your mother is.” d. tell the nurse you are too busy.
d. “Are you wishing you could see your mother?”
44. Before dressing an ECF resident, the nurse aide
38. A client hits you during lunch. The appropriate should
response is to a. close the door and pull the curtain.
a. call the charge nurse for help. b. choose the proper clothes.
b. continue to feed her. c. check for a doctor’s order.
c. apply a restraint. d. all of the above
d. yell at her to stop hitting you.
49
45. Confidentiality refers to 51. Failure to raise the side rails on the bed of a con-
a. never sharing information with anyone. fused client is an act of
b. the right of the patient to privacy. a. malpractice.
c. only sharing information with those involved b. negligence.
in the client’s care. c. overt commission.
d. both b and c d. breaking a criminal law.
46. As a nurse aide, it is your responsibility to 52. During a job interview, it is important to tell the
a. plan the client’s care. interviewer about your
b. do the tasks the supervisor assigns to you. a. scheduling needs.
c. do the best you can without asking for help. b. childcare needs.
d. compare assignments with your coworkers. c. qualifications.
d. all of the above
47. Maintaining good interpersonal relationships
depends on 53. When you are unable to work due to illness, you
a. going along with the crowd. should
b. communicating clearly with others. a. arrange for someone to cover for you.
c. following orders without questioning. b. call the facility as early as possible.
d. all of the above c. call your charge nurse an hour before your
scheduled time.
48. If you do not know how to do an assigned task, d. notify the facility at least 30 minutes before
you should your scheduled time.
a. call another nursing assistant for help.
b. ask the client how she prefers to have it done. 54. The primary reason for laundering a nursing
c. call the charge nurse and ask for help. uniform after each day’s wearing is to
d. follow the instructions in the procedure a. look professional.
manual. b. look neat.
c. remove body odor.
49. Reporting exactly what you see is an example of d. prevent the spread of germs.
a (an) observation.
a. clinical 55. The client asks to see a priest. The nurse aide
b. objective should
c. personal a. ask the charge nurse to call a priest.
d. subjective b. tell the client to see if a priest walks by his or
her door.
50. The purpose of using restraints is to c. call the doctor.
a. position an atrophied extremity. d. tell the client to call herself.
b. protect the client and others from injury.
c. prevent wandering in the halls.
d. all of the above
50
– CHAPTER TITLE
56. When caring for a client who has just been 59. A client is hearing impaired. The client has the
placed on NPO, the nurse aide should first right to
a. encourage the client not to think about food a. written notes.
and water. b. a professional interpreter.
b. encourage the client to eat and drink. c. assistance with hearing aids.
c. remove the water pitcher and all items of food d. all of the above
and drink.
d. give the client meticulous mouth care. 60. A coworker states that she will need help in lift-
ing a heavy client. The nurse aide should
57. A client states that his wallet is lost. The FIRST a. offer to get a Hoyer lift.
action of the nurse aide would be to b. locate additional coworkers.
a. help to look for it. c. state that she has back trouble.
b. notify the doctor. d. a and b
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.
51
– CHAPTER TITLE
Pretest Exam 2
1. d. Any patient who is bed bound may develop a 1. a. Take care of spills immediately, or a patient
decubitus ulcer. Those who also are inconti- may be injured while waiting for housekeep-
nent, paralyzed, or poorly nourished will ing.
develop ulcers more rapidly.
2. a. Always call for help first in an emergency.
2. a. A resident must be able to support some
3. d. When making an occupied bed, it is impor-
weight before using a walker.
tant to make half of the bed at one time, to
3. b. If the cane is not used on the strong side, the have one side rail up and one down, and to
resident may fall. make a toe pleat in the top covers.
4. c. Active ROM means the resident moves his or 4. d. While choices a and b are correct, there is no
her own limbs. data to suggest that choice c is correct.
5. b. Choice a is incorrect because it is impossible 5. c. Always make sure the resident is allowed to
to move the walker and the feet at the same get up first.
time. Choices c and d are incorrect because
6. c. Only respirations are out of normal range.
you should encourage clients not to slide their
feet or the walker. 7. d. All three answers are correct.
6. d. Correctly positioning a patient should prevent 8. b. Systolic is always marked as the first clear
skin breakdown, increase comfort, and main- sound.
tain the function of joints and muscles.
9. b. The abbreviation q.o.d. means every other
7. c. Choice c is the only answer that addresses res- day.
ident privacy, modesty, and personal choice.
10. c. Infection control (hand washing) is always the
8. c. Turning the resident is the easiest method, first step in a procedure.
and it is important to hold the pan to prevent
11. c. Only sterilizing destroys bacteria.
spilling the contents.
12. c. Always remove the resident from danger first.
9. d. The correct answer is obtained by subtracting
the amount of fluid left from the fluid 13. d. Choice a is wrong because the flow is set by
amount the resident started with. the physician. Choice b is wrong because wool
can cause sparks, and c is wrong because alco-
10. b. Always bring such complaints to the charge
hol causes drying. Therefore, only choice d is
nurse.
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.
52
16. b. It is mandatory to provide a certified inter- 29. c. The other answers do not address the resi-
preter to clients not fluent in English. dent’s right to practice religion or her right to
choice.
17. b. Only an identification band is a sure thing. A
confused patient may answer to any name. 30. a. Not all dying patients have the same prob-
lems, but they have all the same care needs as
18. c. All residents need nail care. The nursing assis-
anyone else.
tant should be able to obtain information
needed from the care plan. 31. c. Because each dying resident has unique emo-
tional needs, each person will go through the
19. b. Material may build up under the foreskin in
stages at different times and in different order.
uncircumcised males unless the foreskin is
retracted for cleaning. 32. b. Only choice b is usually seen in dementia.
20. d. A correctly given backrub improves circula- 33. d. Physical and mental wasting away are com-
tion, thus relaxing the patient while giving mon symptoms of Alzheimer’s disease, as is
you an opportunity for one-on-one interac- frequent pacing or wandering and loss of
tion. memory.
21. a. There may be many reasons for dry skin, 34. b. Patients who use their call bell frequently are
including medication reactions. The charge usually afraid they will be ignored if they
nurse should see the problem before any don’t call often. Stopping in frequently reas-
lotion is applied. sures them.
22. d. Choices a, b, and c are all common causes of 35. d. As people age, many suffer loss of income
decubitus ulcers. (retirement usually means a fixed income),
physical strength, and loved ones.
23. d. Choices a, b, and c are all expected outcomes
of a shampoo. Therefore, d is the best answer. 36. d. A person’s total environment always affects
everything that person does and thinks.
24. a. Remove the sleeve from the arm without tub-
ing first. 37. d. “Are you wishing you could see your mother?”
is the only response that uses therapeutic
25. b. The patient may not be eating due to personal
communication skills.
dislike of the food. Asking first allows you to
request a replacement if the problem is this 38. a. Obtaining assistance is the only correct way to
simple. deal with abuse by a resident.
26. c. Any diet question must be answered before 39. d. Federal and state laws require reporting of any
the resident eats. abuse, whether it comes from staff, family, or
other residents.
27. c. Transferring safely means planning ahead,
including obtaining help. 40. c. Position of weights in traction is ordered by a
doctor. Therefore, the nursing assistant should
28. b. Orthostatic hypotension is the light-headed
never change the position of weights without
feeling we all get when we rise too fast.
an order.
53
41. b. Every resident with dentures must have a 49. b. Objective means something you can see, feel,
labeled denture cup to ensure security of the smell, or touch.
costly dentures.
50. b. According to federal law, protection from
42. b. All residents have the right to their own per- injury to self or others is the only acceptable
sonal possessions. Labels allow you to better reason for using restraints.
provide protection.
51. b. Negligence is an unintentional act of injury.
43. c. The resident has the legal right to decide on
52. c. A job interview is the time to sell yourself, so
keeping or throwing away personal belong-
tell the interviewer your qualifications. You
ings.
should not discuss childcare or scheduling
44. a. Choice b is incorrect because some residents needs until after you are offered the job.
are capable of choosing their own clothing.
53. b. Each shift you work may have a different time
Choice c is incorrect because there will not be
requirement.
a doctor’s order for dressing. Choice d is
therefore also incorrect. 54. d. Preventing the spread of germs is the princi-
pal reason for all infection-control measures.
45. d. Choice a is incorrect because important
patient information would be missed if you 55. a. It is a client’s right to have clergy available as
never shared information with anyone. Choice requested.
d is the correct answer because both b and c
56. c. NPO means nothing by mouth, so removing
are true.
all food and water will reduce temptations.
46. b. Choice a is incorrect because you are a mem-
57. d. The first step for any lost belongings is always
ber of the planning team, not the major plan-
to notify the charge nurse.
ner. Choice c is incorrect because in
healthcare the correct action is often to ask for 58. a. The last sense to leave is hearing. Speak with
help. Choice d is incorrect because there is no kindness and be aware of what you say.
legitimate reason to compare notes with 59. d. Mandates are in place to help the hearing
coworkers. impaired in communication.
47. b. Choices a and c are both incorrect as they may 60. d. It is necessary to work as a team for the safety
lead to poor patient care. Choice d is wrong if and well-being of staff as well as clients.
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.
54
C H A P T E R
Nursing
5 Assistant/Nurse
Aide Practice
Exam 3
CHAPTER SUMMARY
This 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.
Y O 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.
55
Exam 3
1. a b c d 25. a b c d 49. a b c d
2. a b c d 26. a b c d 50. a b c d
3. a b c d 27. a b c d 51. a b c d
4. a b c d 28. a b c d 52. a b c d
5. a b c d 29. a b c d 53. a b c d
6. a b c d 30. a b c d 54. a b c d
7. a b c d 31. a b c d 55. a b c d
8. a b c d 32. a b c d 56. a b c d
9. a b c d 33. a b c d 57. a b c d
10. a b c d 34. a b c d 58. a b c d
11. a b c d 35. a b c d 59. a b c d
12. a b c d 36. a b c d 60. a b c d
13. a b c d 37. a b c d 61. a b c d
14. a b c d 38. a b c d 62. a b c d
15. a b c d 39. a b c d 63. a b c d
16. a b c d 40. a b c d 64. a b c d
17. a b c d 41. a b c d 65. a b c d
18. a b c d 42. a b c d 66. a b c d
19. a b c d 43. a b c d 67. a b c d
20. a b c d 44. a b c d 68. a b c d
21. a b c d 45. a b c d 69. a b c d
22. a b c d 46. a b c d 70. a b c d
23. a b c d 47. a b c d
24. a b c d 48. a b c d
57
6. You notice that Mrs. Small’s vital signs are

Exam 3 decreasing and her respirations are zero. You
SHOULD
1. Inactivity and immobility may cause all of the a. continue with her normal care.
following EXCEPT for b. wait five minutes and take her vital signs
a. skin breakdown. again.
b. permanent contractures. c. tell the family that she is dead.
c. increased intestinal peristalsis. d. contact the charge nurse immediately.
d. secretions remaining in the lungs.
7. After Mrs. Small’s death, her husband wishes to
2. The nurse aide knows that the term “up ad lib” share his feelings and emotions. The nurse aide
means the client SHOULD
a. is not permitted out of bed. a. listen and try to comfort him.
b. is independent with balanced periods of rest b. change the subject.
and activity. c. tell him to go to a counselor.
c. is out of bed at mealtime only. d. tell him to keep his feelings to himself.
d. will need assistance of two for all activities of
daily living. 8. An example of a special device to help prevent
contractures is a (an)
3. Mr. Perez is very weak and uncoordinated from a a. handroll.
previous stroke. The nurse aide selects which b. doppler.
device to assist Mr. Perez in walking safely? c. air mattress.
a. geri-chair d. manometer.
b. transfer belt
c. trochanter roll 9. Saying that a coworker took a client’s money
d. Hoyer lift when this is UNTRUE is an example of
a. negligence.
4. A common sign of approaching death is b. assault.
a. increased appetite. c. defamation.
b. normal or elevated vital signs. d. hoarding.
c. severe, unceasing pain.
d. decreased body functions. 10. Paraplegia refers to paralysis of the
a. legs or lower part of the body.
5. The BEST definition of the range-of-motion b. the left half of the body.
term abduction is to c. all four extremities.
a. bring a body part to a center or middle line. d. arms or upper part of the body.
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.
59
11. The MOST accurate method of measuring body 16. Which of the following is an intake-and-output
temperature is problem that the nurse aide MUST report?
a. rectal. a. The client states that he is not hungry.
b. oral. b. The client requests a bedpan.
c. axial. c. The client has not voided in eight hours.
d. feeling the forehead. d. The client’s eight-hour output is 600 cc.
12. Which of the following sets of vital signs should 17. Mrs. Brown’s water pitcher holds 600 cc. The
be reported IMMEDIATELY? pitcher is full at the beginning of the shift.
a. T–98.6, P–60, R–14, BP–120/60 Halfway through the shift, the pitcher is empty,
b. T–102.4, P–100, R–32, BP–180/100 and you refill it. At the end of the shift, the
c. T–99.6, P–80, R–16, BP–132/70 pitcher is one-half full. Total water intake for the
d. T–97.6, P–82, R–20, BP–110/60 shift is
a. 1,200 cc.
13. A large glass holds 240 cc. The patient drank b. 600 cc.
one-third of the large glass. The nurse aide c. 900 cc.
would record this as d. 300 cc.
a. 13 of 240 cc.
b. 30 cc. 18. The nurse aide finds a damaged piece of equip-
c. 80 cc. ment. The nurse aide SHOULD
d. 120 cc. a. dispose of it immediately.
b. use it until new equipment arrives.
14. Mr. Jones is placed on strict intake and output c. report it immediately.
after surgery. The nurse aide SHOULD d. repair it herself and then use it.
a. keep Mr. Jones NPO.
b. record all of the solid foods Mr. Jones eats. 19. The nurse aide shouts at Mr. Moore for climbing
c. record all fluid intake and output every shift. out of bed. This behavior is not acceptable and is
d. measure only the first voiding after surgery. considered to be
a. verbal abuse.
15. Which of the following would be included in a b. neglect.
client’s output record? c. physical abuse.
a. urine, food eaten, and IV solutions d. none of the above
b. urine, emesis, and bleeding
c. liquids taken in during the shift 20. The nurse aide finds ants in the client’s room.
d. bowel movements only 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 26. The nurse aide notices that Mrs. Nix has an open
SHOULD report red area on her coccyx that is draining. The
a. the type of device being used. nurse aide SHOULD
b. the time the restraint was released. a. wash the area with soap and water and apply
c. any unusual observations about the patient’s alcohol.
skin condition. b. ask another nursing assistant to look at it and
d. all of the above give her opinion.
c. check it again at the same time the next day.
22. The pulse located in the neck is called the d. tell the charge nurse so she can check it.
a. apical pulse.
b. femoral pulse. 27. While you are walking Mrs. Grey in the hallway,
c. radial pulse. she complains of chest pain and dizziness. Your
d. carotid pulse. FIRST response should be to
a. sit her on the floor and go get help.
23. Mrs. Wilson complains of numbness on one side b. call for help immediately but stay with her.
of her body. You notice that her grip is weak and c. continue the walk so as not to alarm her.
her speech is slurred. You SHOULD d. tell her to relax because everything will be
a. realize that this may be a sign of a CVA and okay.
notify the charge nurse.
b. call the doctor and tell him Mrs. Wilson had a 28. Mr. Smith has just smoked a cigarette. It is time
CVA. to take his temperature. The nurse aide
c. check to see if Mrs. Wilson’s condition is the SHOULD
same the next day. a. wait 15–20 minutes and then take an oral
d. accept the condition as normal and reassure temperature.
Mrs. Wilson. b. take an oral temperature immediately.
c. give him some cold water to counter the effect
24. Common signs and symptoms of a urinary tract of smoking and then take an oral tempera-
infection may include ture.
a. extreme thirst and hunger. d. take a rectal temperature to discourage him
b. lack of appetite and stomach pain. from smoking.
c. constipation alternating with diarrhea.
d. frequent urination with burning sensation. 29. Which of the following observations should be
reported IMMEDIATELY?
25. The order “vital signs q.i.d.” means to record a. T–98.2, P–88, R–20
vital signs b. yellow-colored urine
a. four times per day. c. bluish tint to lips and skin
b. twice per day. d. skin that is warm and dry to the touch
c. morning and evening.
d. once per shift.
61
30. Microorganisms can be spread by direct and 34. As you feed Mrs. Sanford, she begins to choke.
indirect contact. An example of indirect contact is Mrs. Sanford is conscious, but she is unable to
a. bathing the patient. speak or cough. The nurse aide SHOULD
b. using contaminated blood. a. administer abdominal thrusts.
c. touching objects or dirty instruments. b. look in her mouth to see what she is choking
d. breathing dust particles in the air. on.
c. get the doctor at once.
31. Which statement about the hand-washing proce- d. keep feeding her to push the food down.
dure is CORRECT?
a. The faucet is clean and may be touched dur- 35. The nurse aide SHOULD tell the licensed nurse
ing hand washing. if a patient with does not finish the
b. Wash at least two inches above the wrist. food on his tray.
c. As long as soap is used, the temperature of the a. stroke
water doesn’t matter. b. cancer
d. All of the above are correct. c. diabetes
d. Alzheimer’s disease
32. The call light in the shower comes on. As you
enter the shower, you find Mrs. Shepard lying on 36. Techniques to keep the client’s skin clean and
the floor. You should IMMEDIATELY healthy include
a. run back to the nurses’ station to get help. a. using prescription soaps only.
b. help her to a chair, and then resume her b. using clear water but no soap.
shower. c. rinsing the skin well after soaping.
c. shake her gently and shout “Are you okay?” d. using a lot of suds.
d. scold her for not asking for assistance with her
shower. 37. Giving good oral care to a client includes all of
the following EXCEPT
33. Which statement about use of fire extinguishers a. wearing gloves.
is CORRECT? b. handling and storing dentures carefully.
a. Any fire extinguisher can be used on any fire. c. using dental floss.
b. Each extinguisher should be used for the cor- d. removing oxygen before brushing.
rect type of fire.
c. Nurse aides are not responsible for using fire 38. To prevent infection in a client with an
extinguishers. indwelling catheter, the nurse aide SHOULD
d. Fire extinguishers should not be used around a. keep the drainage bag higher than the bladder.
patients. 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 44. When clients are in a healthcare institution, they
expect to find which of the following food items expect to be treated as stated in the
on his breakfast tray? a. Infection Control Manual.
a. oatmeal, juice, and coffee b. Patient’s Bill of Rights.
b. pureed eggs and toast c. Policy and Procedure Manual.
c. clear broth, gelatin, and milk d. Physician’s Code of Ethics.
d. pancakes, bacon, and tea
45. A conversation about a client in the hospital’s
40. Which statement about injuries to clients and elevator is against the
staff members is CORRECT? a. client’s right to privacy.
a. Injuries should be treated and reported on an b. client’s right to medical care.
incident report. c. client’s right to review their records.
b. Injuries can be ignored if they are minor. d. client’s right to ask questions.
c. Injuries should be reported only if they are
major. 46. Several members of the healthcare team have
d. Injuries should be treated but do not need to received verbal sexual comments from Mr. Har-
be reported. ris, a client on the unit. In discussing this prob-
lem at a staff meeting, the team decides the
41. Which statement about horseplay and practical MOST appropriate response would be
jokes is CORRECT? a. “You are making me blush, Mr. Harris.”
a. They are permitted if no one is insulted. b. “Mr. Harris, your comments are not accept-
b. They are acceptable during breaks. able to me.”
c. They can cause accidents and are unaccept- c. “You really have a great sense of humor, Mr.
able. Harris.”
d. They are allowed because they cheer up the d. “Mr. Harris, you really should be ashamed of
patients. yourself!”
42. The nurse aide used an electric razor to shave 47. Which one of your five senses would BEST
Mr. Bailey and nicked him on the chin. The detect Joan Dillon’s body rash?
nurse aide SHOULD a. sight
a. ignore the nick and continue. b. smell
b. call the doctor. c. touch
c. report the nick to the licensed nurse. d. hearing
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.
63
48. The BEST way a nurse aide can clean an infant’s 52. A two-month-old infant has been crying contin-
eyes is with a (an) uously. The nurse aide SHOULD
a. Q-tip swab lubricated with Vaseline. a. check the baby’s diaper.
b. moist cotton ball, wiping from the inner to b. see if it is time for a feeding.
the outer corner. c. cuddle or rock the baby.
c. alcohol wipe, using circular motions. d. all of the above
d. hot towel, wiping from the outer to the inner
corner. 53. Mrs. Beck’s husband refuses to leave the room in
which you are bathing her. You SHOULD
49. Mrs. Enbody is hard of hearing and repeatedly a. insist that he leave.
turns her call light on. When responding to her b. allow him to help you.
call light, the nurse aide SHOULD c. refuse to bathe Mrs. Beck.
a. take time to listen to her to determine her d. say “Fine, do it yourself,” and leave.
needs.
b. talk loudly to her since she is hard of hearing. 54. While providing personal care for a client, the
c. unplug the call light. nurse aide SHOULD
d. tell the charge nurse that Mrs. Enbody is a. uncover the client completely so he or she can
uncooperative. work quickly.
b. uncover only the area he or she is working on.
50. Mrs. Jones states, “I’m not nervous about this c. keep the client completely covered and work
surgery,” but she is restless and unable to get under the covers.
comfortable. The nurse aide SHOULD d. leave the curtain open at all times.
a. recognize that Mrs. Jones’s body movements
indicate fear and ask the nurse to speak with 55. When providing morning (A.M.) care for the
her. client, the nurse aide SHOULD
b. pad the side rails on the bed to prevent an a. let the client do as much as he is able to.
accident. b. do everything for the client so it is done cor-
c. ask Mrs. Jones’s family members to leave so rectly.
she will be able to settle down. c. care only for clients who are the same sex.
d. tell her everyone is nervous about surgery and d. work as quickly as possible.
that she should relax.
56. After Mr. Hall’s stroke, his right arm is weak and
51. Which member of the healthcare team is respon- stiff. He SHOULD be taught to
sible for the client’s discharge plan? a. put his right arm into his shirt first.
a. nurse aide b. put his left arm into his shirt first.
b. ward/unit clerk c. put both arms in the shirt at the same time.
c. registered nurse d. wear a gown to make dressing easier.
d. dietician
64
– CHAPTER TITLE
57. Dressing will be difficult for a client who 62. What is MOST important to show the client in
a. has a contracted arm. his new room?
b. is left-handed. a. the television remote control
c. has impaired speech. b. how to lower and raise the bed
d. is elderly. c. the location of the call bell and how to use it
d. where to store personal belongings
58. If a client objects to certain food for religious or
cultural reasons, the nurse aide SHOULD 63. The older adult likes to feel positive about him-
a. tell him to grow up and eat like an adult. or herself by sharing past achievements and
b. offer to get something different for him. experiences. The BEST way the nurse aide can
c. tell him he will have to speak to the dietician encourage this is by
tomorrow. a. pairing the older adult with another talkative
d. tell him he will be given a tube feeding if he resident.
won’t eat. b. encouraging frequent rest periods to save
energy for socializing.
59. Bill, a terminally ill resident, refuses his bath and c. listening to the older adult’s past experiences.
throws the water basin across the room. He is in d. telling the older adult that you are too busy to
what stage of dying? listen to stories.
a. denial
b. bargaining 64. In caring for the client with anxiety, the nurse
c. acceptance aide SHOULD
d. anger a. remain calm.
b. use simple, easy-to-understand words.
60. Mrs. Jones begs, “Just let me live until my grand- c. provide a quiet atmosphere.
child is born.” She is in what stage of dying? d. all of the above
a. acceptance
b. anger 65. A client asks the nurse aide if she could have a
c. bargaining few minutes to pray before her bath. The BEST
d. denial response by the nurse aide would be to
a. tell her that her bath comes first.
61. An important thing the nurse aide can do for a b. allow her some private time to pray.
dying client is to c. tell her to wait until clergy visits.
a. leave him alone to allow for privacy. d. ignore her request and start bathing her.
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.
65
66. During orientation of your new job, you realize 68. When the nurse aide shows genuine interest and
your shift ends at 3:30 P.M. and not at 3:00 P.M. as concern for the client, this is an example of
you had thought. Your child needs to be picked a. honesty.
up every day by 3:15 P.M. You SHOULD b. caring.
a. discuss this with the charge nurse as soon as c. teamwork.
possible. d. accuracy.
b. ask the other nurse aide to cover you for fif-
teen minutes. 69. When you are giving a bedbath to a client, you
c. leave early and hope no one notices your SHOULD
absence. a. put the bed in the low position.
d. come in 15 minutes earlier in the morning. b. cover the resident with a bath blanket.
c. wash the perineal area from back to front.
67. The BEST definition of a certified nursing assis- d. put the dirty towels and linen on the floor.
tant is a
a. graduate nurse who is registered and licensed 70. An indwelling catheter drains the bladder of
by the state to practice nursing. a. feces
b. licensed person who provides education about b. emesis
special diets. c. urine
c. person who transcribes the physician’s orders d. blood
for patient care.
d. person who is certified to give care under the
direct supervision of a registered or licensed
practical nurse.
66
Exam 3 14. c. Any fluid taken in or released from the body is

1. c. Intestinal peristalsis decreases with inactivity considered when the patient is on I and O.
and immobility.
15. b. Urine, emesis, and bleeding are all considered
2. b. “Up ad lib” is an activity order suggesting the output.
client can perform ADLs independently with
16. c. Failure to void (urinate) may indicate kidney
periods of rest as needed.
failure.
3. b. A transfer belt (also called safety, ambulation
17. c. 600 cc + 300 cc (half of the pitcher) is the
belt) is used by caregivers to assist the client to
total, or 900 cc.
transfer or walk safely.
18. c. Reporting damage to equipment immediately
4. d. As circulation slows, body functions decrease.
will prevent an accident.
5. d. Abduction refers to the movement of a body
19. a. Verbal abuse such as shouting or name calling
part away from a center or middle line.
is not professional behavior and violates the
6. d. Lack of respiration and low vital signs may client’s rights.
signify approaching death. Report this imme-
20. b. Insects carry diseases and should not be found
diately.
in the health care setting.
7. a. Caring for the family is just as important as
21. d. All checks are necessary to prevent accidents
caring for the client. Allow the husband to
from occurring.
vent his feelings.
22. d. The carotid pulse is located in the neck.
8. a. A handroll is placed in the palm of the hand
to prevent the hand and fingers from con- 23. a. The nurse aide must be familiar with unusual
tracting in the flexed position. signs and symptoms and report them as soon
as possible.
9. c. Defamation is harming a person’s reputation
by words that you say (slander) or write (libel) 24. d. Both signs and symptoms are due to the infec-
intentionally. tious process.
10. a. Paraplegia is paralysis of the leg or lower part 25. a. “Q.i.d.” means four times per day.
of the body.
26. d. An opening in the skin predisposes the client
11. a. The rectal temperature method is considered to infection and must be checked by the
the most accurate as the thermometer is in nurse.
direct contact with membranes.
27. b. Never leave a patient alone in the time of an
12. b. A temperature of 102.4 is elevated. The emergency. Get help immediately.
patient’s pulse indicates tachycardia. The
28. a. Smoking may cause a misreading of the
patient also has hypertension.
client’s body temperature.
13. c. One-third of 240 equals 80.
67
29. c. Blush discoloration (cyanosis) indicates a low 44. b. Patient’s Bill of Rights is a written statement
oxygen level in the body. The condition can be that includes the rights clients are entitled to
life threatening. when receiving healthcare.
30. c. Objects such as bed linens, dishes, and dirty 45. a. Conversations regarding a client should never
instruments harbor microorganisms. take place in a public area such as an elevator.
This violates the client’s right to privacy.
31. b. Washing above the wrist is part of the correct
hand-washing procedure. 46. b. Sexual comments by a client are inappropri-
ate. The health worker must let the client
32. c. Shake and shout to determine if the client is
know that the comments are unacceptable.
oriented and/or conscious.
47. a. Skin rashes are observed by inspecting the
33. b. Different extinguishers are used on various
body daily.
types of fires.
48. b. Infant’s eyes are cleaned from inner to outer
34. a. The abdominal thrust will dislodge the food.
to prevent the spread of infection. A moist
35. c. A diabetic’s blood sugar is controlled by diet cotton ball is soft and will not injure the eye.
and medication. Any food not eaten will affect
49. a. Listening carefully to the patient’s needs
the blood sugar level.
encourages communication and builds trust.
36. c. Rinsing the soap off thoroughly helps prevent
50. a. Nonverbal communication such as body
drying of the skin.
movement indicates the client’s anxiety.
37. d. Oxygen does not interfere with oral hygiene.
51. c. The registered nurse is the team member
38. b. Always wipe from front to back to prevent listed who is responsible for the discharge.
rectal germs from entering the vagina or uri-
52. d. Crying indicates the infant needs attention.
nary tract.
Check or do all of the above.
39. c. Any liquids are considered to be part of a full-
53. b. Encourage family members to be involved in
liquid diet, including milk products.
all aspects of care.
40. a. Minor and major injuries must be docu-
54. b. Covering the areas you are not working on
mented.
will allow privacy and keep the body warm.
41. c. The role of the caregiver is to act profession-
55. a. Encouraging independence allows clients to
ally and focus on the client care.
feel self-worth by participating in their own
42. c. Any body scratches, lacerations, or cuts must care.
be reported immediately.
56. a. Always put the affected limb into the clothing
43. c. Body language includes posture, gestures, and first to prevent injury to the limb.
facial expressions that a person uses in com-
57. a. The contracted arm limits the range of
municating with others.
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 65. b. Respecting a client’s spiritual needs is an
appropriately. important aspect of the client’s care.
60. c. The stages of death vary from client to client 66. a. Being honest and up-front with your supervi-
as death occurs. Assist Mary in expressing her sor is the best approach.
concerns.
67. d. This is the only correct definition of a certified
61. b. All aspects of care are vital to terminal clients. nursing assistant. The nurse assistant is always
under the direct supervision of a licensed
62. c. Providing a means to call a nurse is important
nurse.
to avoid injury and meet the client’s needs.
68. b. Nursing is caring. It is an attitude of interest
63. c. Listening tells the clients you are interested in
and concern.
what they have to say.
69. b. Privacy and warmth are in accordance with
64. d. Remain calm, using simple and easy words to
the client’s Bill of Rights.
understand, and providing a quiet atmosphere
are all conducive to caring for a client with 70. c. A catheter inserted in the bladder drains urine
anxiety. from the body.
69
C H A P T E R
Nursing
6 Assistant/Nurse
Aide Practice
Exam 4
CHAPTER SUMMARY
This 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.
T HIS IS THE second-to-the-last sample National Nurse Aide Assessment Program (NNAAP) written
exam in this book. It is not any harder than the other three have been. It is simply another 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.
71
Exam 4
1. a b c d 25. a b c d 49. a b c d
2. a b c d 26. a b c d 50. a b c d
3. a b c d 27. a b c d 51. a b c d
4. a b c d 28. a b c d 52. a b c d
5. a b c d 29. a b c d 53. a b c d
6. a b c d 30. a b c d 54. a b c d
7. a b c d 31. a b c d 55. a b c d
8. a b c d 32. a b c d 56. a b c d
9. a b c d 33. a b c d 57. a b c d
10. a b c d 34. a b c d 58. a b c d
11. a b c d 35. a b c d 59. a b c d
12. a b c d 36. a b c d 60. a b c d
13. a b c d 37. a b c d 61. a b c d
14. a b c d 38. a b c d 62. a b c d
15. a b c d 39. a b c d 63. a b c d
16. a b c d 40. a b c d 64. a b c d
17. a b c d 41. a b c d 65. a b c d
18. a b c d 42. a b c d 66. a b c d
19. a b c d 43. a b c d 67. a b c d
20. a b c d 44. a b c d 68. a b c d
21. a b c d 45. a b c d 69. a b c d
22. a b c d 46. a b c d 70. a b c d
23. a b c d 47. a b c d
24. a b c d 48. a b c d
73
6. The nurse aide, a member of the healthcare

Exam 4 team, can participate in the nursing process
EXCEPT for
1. When assisting a blind client to eat, the nurse a. collecting data.
aide SHOULD b. planning the care.
a. set the plate as a clock with food at 1:00, 5:00, c. making observations.
8:00, and 11:00. d. carrying out selected interventions.
b. set the plate as a clock with food at 12:00,
3:00, 6:00, and 9:00. 7. When using crutches, the client’s weight MUST
c. give him the plate and tell him where the rest on the
food is. a. armpit.
d. feed him herself to save time. b. knees.
c. hand rests.
2. Lena, a 70-year-old resident, wishes to write out d. shoulders.
her own Christmas cards. The nurse aide
SHOULD 8. How often should a client be repositioned if he
a. call her daughter to do it for her. cannot move himself?
b. provide her with supplies and an appropriate a. every hour
working space. b. every two hours
c. let her manage it entirely by herself. c. every three hours
d. write the Christmas cards out for her. d. every four hours
3. A cane SHOULD be used on 9. Correct range of motion for the neck includes
a. the affected side. a. flexion, extension, hypertension, and rotation.
b. the unaffected side. b. abduction, adduction, flexion, and extension.
c. either side, depending on how the client feels. c. rotation, abduction, adduction, and extension.
d. the weak side one day and the strong side the d. pronation, supination, and flexion.
next.
10. The goal of bladder training is to
4. The client who is at high risk of developing a a. stop using a catheter.
pressure sore is one who b. gain voluntary control of urination.
a. eats poorly. c. prevent skin problems caused by inconti-
b. moves herself often. nence.
c. has an unwrinkled bed. d. all of the above
d. has Alzheimer’s disease.
11. Mr. Scranton sometimes chokes while he is eat-
5. Which of the following helps prevent decubitus ing. The nurse aide SHOULD
ulcers? a. stay close by while he is eating.
a. bed rest b. instruct his roommate to watch him eat.
b. liquid diet c. feed him to prevent problems.
c. back rubs d. use the Heimlich maneuver between bites.
d. support hose
75
12. If a client complains of a burning, tingling area 17. Safety precautions for hot treatments SHOULD
on his skin, you should FIRST include
a. rub the area well with lotion. a. leaving on the treatment for the time ordered.
b. report the complaint to the licensed nurse. b. stopping the treatment if the skin is reddened.
c. keep an eye on the area for a few days. c. giving the treatment through a protective pad.
d. use cornstarch on the area. d. both a and b
13. When changing a pillowcase, you should NOT 18. The nurse aide has been caring for Mrs. Jewell
hold the pillow under your chin because this for four hours, and during that time she has
would asked the aide to take her to the bathroom every
a. tear the pillowcase. fifteen minutes. The nurse aide’s BEST action
b. drop the pillowcase. is to
c. dampen the pillowcase. a. trade clients with another nurse aide.
d. spread bacteria. b. put her to bed on a waterproof underpad.
c. discuss this issue with the licensed nurse.
14. A nonsterile dressing is one that is d. ignore her for a while.
a. wet
b. dry 19. If an elderly resident begins to wander and
c. clean becomes confused, you SHOULD
d. new a. leave her in her pajamas for easier care.
b. joke with her about her funny ideas.
15. If you are asked to clean or put a soak on a resi- c. report her behavior for evaluation.
dent’s eye, you SHOULD d. tell her family she is near death.
a. clean it from the inner corner to the outer
edge. 20. The Hoyer lift is used to
b. use a clean surface of the cloth each time you a. prevent injuries to healthcare workers.
touch the eye. b. move clients who are very heavy or weak.
c. report any exudate. c. move a client when only one worker is free.
d. all of the above d. all of the above
16. Before giving any hot or cold treatment, the 21. When you perform passive range-of-motion
nurse aide should be sure to have exercises for a resident, you should do all the fol-
a. a doctor’s order. lowing EXCEPT
b. a sign for the door. a. use good body mechanics.
c. disposable equipment. b. move the joint until the resident feels pain.
d. a form to chart on. c. keep the body covered except for the joint
being exercised.
d. make the resident perform as much of the
exercising as he can.
76
22. Using a broad base of support means 28. When the nurse aide is transferring a client from
a. keeping your feet comfortably apart. the bed to the wheelchair, she should ALWAYS
b. keeping your knees locked in place. a. unlock the brakes on the wheelchair.
c. holding objects away from your body. b. lock the brakes on the wheelchair first.
d. all of the above c. use a Hoyer lift.
d. put socks on the client first.
23. If a client is in traction, you should NOT
a. monitor affected skin temperature. 29. Before any transfer, the nurse aide SHOULD
b. give a complete bedbath. a. have the nurse’s approval.
c. change the position of the weights. b. know the proper procedure.
d. monitor distal pulses. c. use a transfer belt if needed.
d. all of the above
24. When the nurse aide is moving the client up in
bed, the pillow goes 30. The pulse located in the wrist is called the
a. on the chair, out of the way. a. carotid pulse.
b. at the foot of the bed, out of the way. b. apical pulse.
c. at the head of the bed, to protect the head. c. femoral pulse.
d. anywhere the client wants it. d. radial pulse.
25. Dangling a client’s legs over the side of the bed is 31. Mr. Salzberg drinks five ounces of juice. The
done to nurse aide would record this as
a. make sure she is able to sit up first. a. 500 cc.
b. give her time to put on her shoes. b. 150 cc.
c. prevent decubitus ulcers. c. 6 cc.
d. prevent orthostatic hypotension. d. 5 cc.
26. Walking with a client is safest if done with a 32. Which of the following sets of vital signs should
a. transfer belt. be reported IMMEDIATELY?
b. wheelchair a few steps behind him. a. T–98.2 P–122 R–20 BP–84/40
c. Hoyer lift. b. T–99.0 P–72 R–16 BP–134/82
d. nurse or doctor ready for emergencies. c. T–98.8 P–66 R–14 BP–100/62
d. T–98.6 P–90 R–18 BP–120/70
27. When you have a client sit up and dangle her legs
before getting up, you should watch for 33. A piece of linen that is placed beneath the client
a. sudden paleness. from shoulders to thighs is called
b. excessive sweating. a. an underpad.
c. increased respirations. b. a spread.
d. all of the above c. a drawsheet.
d. a sheet.
77
34. Which bedmaking procedure is used when the 39. A resident with a paralyzed left arm may be able
client remains in the bed? to feed herself if she uses a
a. occupied bedmaking procedure a. plate guard.
b. unoccupied bedmaking procedure b. built-up spoon.
c. circle bedmaking procedure c. zipper pull.
d. procedure using only fitted sheets d. a and b only
35. Which complication may happen if a post-op 40. Which statement about residents with mental
client does NOT take in adequate fluids? retardation is generally CORRECT?
a. constipation a. They should be treated like children.
b. blood clots b. They cannot walk or talk.
c. infection c. They learn at a slower pace.
d. foot drop d. They are suspicious of all teenagers.
36. Which type of client is most likely to have prob- 41. A diabetic client has had her leg amputated. Her
lems as a result of poor nail care? need for sexuality will
a. a cancer client a. be more important for a while.
b. a diabetic client b. be less important for a while.
c. a stroke client c. disappear forever.
d. a mentally retarded client d. be unaffected.
37. Mrs. Nelson has right-sided weakness. For her 42. Clients with Alzheimer’s disease may show which
mouth care, the nurse aide SHOULD of the following symptoms?
a. do it for her. a. high fever accompanied by chills
b. pay particular attention to the left side of her b. clear memory of the recent and distant past
mouth. c. chest pains and difficulty breathing
c. tell her to get out the equipment and do it d. physical and mental decline
herself.
d. let her do as much as she can and assist as 43. If a client is upset and is yelling, the nurse aide
needed. SHOULD respond by
a. saying sternly, “Quiet down!”
38. A cane, walker, and crutches are all used to help a b. offering to call her doctor.
client walk. What else do they have in common? c. shutting her door for privacy.
a. Clients must know how to use them correctly. d. calmly sitting down with the client and
b. They all must have rubber tips to prevent slip- listening.
ping.
c. They all must be fitted to the client. 44. A common sign of depression is
d. all of the above 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- 49. Beth is a 58-year-old permanently handicapped
rosis whose mother has always taken care of her. resident. She tends to be very quiet and to act as
It would be normal for Linda to if nothing matters. The nurse aide can BEST
a. look to her father for care. show respect for her by
b. refuse to see her mother. a. telling her she is very lucky to retire so early.
c. want to make her own decisions. b. including her in her plan of care.
d. ask her mother’s advice about everything. c. serving her dinner first.
d. calling her “Mom.”
46. A client who is in middle adulthood would be
likely to be concerned about her 50. An example of using body language while com-
a. teenage children. municating is
b. elderly parents. a. using gestures and facial expressions.
c. grandchildren. b. writing the message on paper.
d. a and b only c. sharing your feelings and concerns.
d. offering your advice and opinions.
47. A Catholic client refuses to eat meat on Fridays.
Her lunch one Friday consists of a roast beef 51. The nurse aide nods her head and smiles while
sandwich and a salad. The nurse aide SHOULD she sits with Mrs. Crane. This type of nonverbal
first communication BEST demonstrates
a. tell the client to eat only the salad. a. encouragement for the client to continue
b. offer to get her a meatless lunch. talking.
c. ask family members to bring in something b. displeasure at having to listen to the client.
else. c. support for the terminally ill client.
d. request that a priest come and speak with her. d. lack of work available for the nurse aide.
48. What is the BEST way you can understand cul- 52. Mr. Jacko states, “I’m feeling really sad today.”
tural practices different from your own? The nurse aide responds by saying, “You are feel-
a. Avoid giving care to clients with cultural prac- ing sad?” This is an example of a communication
tices different from yours. technique called
b. Try to understand other cultural practices by a. active listening.
learning more about them. b. clarification.
c. Eat out at different ethnic restaurants to taste c. silence.
various foods. d. reflection.
d. Discuss your own beliefs and values with
clients whose cultural practices are different 53. If a client asks a question about the health status
from yours. 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 58. Mrs. Larkin, age 52, was the victim of an indus-
to bathe this morning. The BEST response by the trial accident. She was a foreman and a union
nurse aide would be leader. To help her maintain her dignity as an
a. “You are going to bathe today whether you adult, you might suggest that she
like it or not.” a. read industrial magazines.
b. “I don’t think your roommate will appreciate b. serve on the resident council.
the smell in here.” c. rent movies.
c. “Can you tell me why you don’t feel like d. attend bingo.
bathing today?”
d. “Fine with me. I’ll get my work done earlier 59. A client’s daughter wants to help with her
today.” mother’s care. You should tell her that she
a. cannot help.
55. An example of false imprisonment is b. can only bathe her mother.
a. using restraints without a doctor’s order or c. can do whatever care she wants.
the client’s consent. d. can do whatever the nurse agrees to.
b. closing the door to the client’s room.
c. treating the client differently because of their 60. It is important to remember that a client in the
religious beliefs. last stage of a terminal illness SHOULD
d. refusing to answer a call light that rings fre- a. be left alone to grieve.
quently. b. be offered care to meet their physical and
emotional needs.
56. You are aware that a coworker is not providing c. be cared for only by relatives and close
the required care to certain residents on your friends.
floor. The nurse aide SHOULD d. not be offered any choices about their care.
a. keep a list of the activities not performed.
b. tell all the other staff members. 61. Dressing a resident in personal clothing every
c. provide the care yourself. day contributes to the resident’s
d. report this to the charge nurse as soon as pos- a. overall appearance.
sible. b. feeling of well-being.
c. pulse rate.
57. If you are ill and cannot report to work that day, d. a and b only
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.
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– CHAPTER TITLE
62. Mr. Collins, a 42-year-old postoperative client, 66. After assisting a client to the bedside commode,
has his door closed. The nurse aide needs to take the nurse aide SHOULD
a set of routine vital signs. She SHOULD a. leave the curtain open so she can see the
a. knock on the door and wait for the client to client.
respond. b. provide privacy with the curtain pulled.
b. assume this means he does not want to be dis- c. make her bed while she is sitting on the com-
turbed. mode.
c. open the door immediately, as doors should d. tell her she can only use the commode once a
not be closed. shift.
d. knock and enter without waiting for a
response. 67. The healthcare team can include all of the fol-
lowing EXCEPT for the
63. Which of the following are listed in the Patient’s a. nurse aide.
Bill of Rights? b. registered nurse.
a. the right to privacy and confidentiality c. receptionist.
b. the right to make decisions about the plan of d. physical therapist.
care
c. the right to have a living will 68. In order to keep your job as a nurse aide, you will
d. all of the above need to follow institutional guidelines that may
include
64. Mrs. Philly insists on dressing in a striped green a. reporting to work on time.
blouse and plaid pants. Knowing that the clothes b. following the institution’s dress code.
don’t match, the nurse aide SHOULD c. completing only tasks for which you have
a. insist on selecting another outfit for her. been trained.
b. tell her she will look ridiculous in that outfit. d. all of the above
c. respect her choice of clothing.
d. have her remain in her night clothes until she 69. Members of the healthcare team know that the
changes her mind. MOST important reason to all work together
is to
65. Failure to perform service for which a person is a. provide the best possible care to the client.
trained is called b. eliminate arguments among team members.
a. discrimination. c. form long-lasting friendships.
b. malpractice. d. be able to do each other’s assignments.
c. slander.
d. false imprisonment. 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.
81
– CHAPTER TITLE
Exam 4 14. c. A clean dressing is nonsterile but promotes

1. b. Explain to the patient what is located at each protection to the skin. A Band-Aid is an
“time” using the clock method. This promotes example of a clean dressing.
independence.
15. d. Cleaning from the inside outward prevents
2. b. Encourage Lena to do as much as possible by contamination to the other eye. Using a clean
helping her obtain the materials she needs to cloth and reporting any drainage promotes
perform this task. healing.
3. b. This position will provide balance and sup- 16. a. The physician must order any treatments that
port for the client. The cane should be prop- the patient receives.
erly fitted.
17. d. Check the skin frequently for redness and
4. a. Nutritional status affects the health of the skin remove the soak if the patient complains of
and other body systems. burning.
5. c. Back rubs are soothing and promote blood 18. c. Ask the nurse if this is normal behavior for
flow to the area. Mrs. Jewell.
6. b. The planning phase of the nursing process can 19. c. Any unusual or new behavior should be
only be done by the registered nurse. reported for accurate diagnosis by the physi-
cian.
7. c. Proper instructions for hand placement pre-
vent nerve damage, which may cause paralysis 20. d. The lift ensures safety for both client and
to the arm. healthcare worker. It can be used on obese,
paralyzed, or blind residents.
8. b. This is the maximum time a resident should
be left in one position. Frequent turning pro- 21. b. Never extend the joint to the point of pain.
motes good circulation.
22. a. A broad base of 12 inches apart will allow the
9. a. The neck is capable of all the movements center of gravity to assist in the transfer.
listed here.
23. c. Changing the position of weights requires a
10. d. Bladder training promotes a regular pattern of doctor’s order.
continence.
24. c. The pillow provides safety and prevents the
11. a. Observe the patient who has a chewing dys- client from striking the head on the bed.
function. Choking can cause an airway
25. d. Sitting the resident on the side of the bed
obstruction.
allows the blood to drain to the lower extrem-
12. b. This may be an indication of a serious condi- ities and prevents the client from fainting.
tion and should be reported immediately.
26. a. The transfer belt provides a lift mechanism
13. d. Inhaling the bacteria can cause infection to and prevents the client from falling.
the healthcare worker.
82
27. d. Any sudden change in the client’s condition 41. b. The diabetic patient needs to accept the
must be reported immediately. amputation and realize this does not affect
sexuality.
28. b. Locking the brakes will prevent the chair from
rolling and the client from falling. 42. d. The Alzheimer’s patient suffers from physical
and mental decline.
29. d. Always know the procedure you are perform-
ing and use the proper equipment. 43. a. Calm the patient down and allow her to voice
her concerns in a constructive way.
30. d. Though all of the listed options are pulse
points, the radial pulse is located at the wrist 44. c. Lack of appetite may be caused by many dis-
and is most commonly used. eases, especially depression.
31. b. One ounce is 30 cc, so 5 ounces is 5 × 30 or 45. c. Linda has a physical disorder but needs to
150 cc. continue to make her own decisions to keep
her self-esteem and mental-health capability.
32. a. The pulse indicates tachycardia and the BP is
abnormally low. These vital signs need to be 46. d. As middle-aged adults, parents worry about
reported immediately. their teenage children and their elderly par-
ents.
33. c. The drawsheet saves on bed changes and can
be used as a lift sheet to move the client in 47. b. The nurse aide should make every effort to
bed. respect the client’s religious needs.
34. b. When the client is bedridden, the bed sheets 48. b. With learning usually comes greater apprecia-
need to be changed with the client in bed. tion and understanding.
This is called an occupied bed.
49. b. Allow Beth to make decisions about her
35. a. Constipation is a common complication post- healthcare. This will prevent depression and
operatively from the effects from anesthesia. allow her to make choices.
Not taking in adequate fluids will increase the
50. a. Gestures, facial expressions, and posture are
risk of this complication.
all examples of body language.
36. b. Poor nail care can lead to infection in the dia-
51. a. Head nodding and smiling while someone is
betic client. Diabetic clients require licensed
speaking to you demonstrates interest and
personnel to provide nail care.
says, “tell me more.”
37. d. Encourage independence as much as possible.
52. d. Reflection is a communication technique in
38. d. Clients vary in height and weight, and all which the care provider uses key words the
equipment must be safe. client says to reflect a main idea back to them.
It allows the client to expand on the topic.
39. d. Encourage independence by using mechanical
devices to assist the client. 53. b. Always respect the client right of patient con-
fidentiality.
40. c. In many mentally retarded clients, learning is
slower than normal, but it still occurs and 54. c. Asking the question will help determine if
should be encouraged. there are any underlying physical or psycho-
83
logical reasons why the client chooses not to 63. d. All choices are listed in the Patient’s Bill of
bathe. Rights.
55. a. False imprisonment is the act of restraining 64. c. As long as it is a safe choice, allow the client to
another person. make personal choices.
56. d. As a team member, you are required to report 65. b. Malpractice is the failure to give service for
this to the charge nurse. Any activity that which one is trained.
affects patient care needs to be reported.
66. b. As long as the client is safe, provide privacy
57. c. Always call the facility as early as possible so while on the commode.
that they can find a replacement for you.
67. c. The healthcare team is the group of caregivers
58. b. As a former foreman and leader, Mrs. Larkin involved in providing care to patients.
needs to feel useful and involved.
68. d. All of the guidelines listed are necessary to fol-
59. d. If the daughter feels comfortable in caring for low in order to remain employed as a nurse
the client, she should let the nurse know. The aide.
nurse will consider the health of the client.
69. a. The primary function of the healthcare team
60. b. Terminally ill clients have physical and emo- is to provide the best patient care possible.
tional needs that need to be met.
70. b. Saying negative comments about another per-
61. d. Both choices have a positive effect on the resi- son (slander) during a job interview will only
dent. cast a negative image upon yourself. Keep the
interview positive.
62. a. Always knock on a closed door and wait for a
response to ensure client privacy.
84
C H A P T E R
Nursing
7 Assistant/Nurse
Aide Practice
Exam 5
CHAPTER SUMMARY
This is the fifth and final nursing assistant exam. By the time you fin-
ish this exam, you should be prepared for the real thing.
T HIS IS THE 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!
85
Exam 5
1. a b c d 25. a b c d 49. a b c d
2. a b c d 26. a b c d 50. a b c d
3. a b c d 27. a b c d 51. a b c d
4. a b c d 28. a b c d 52. a b c d
5. a b c d 29. a b c d 53. a b c d
6. a b c d 30. a b c d 54. a b c d
7. a b c d 31. a b c d 55. a b c d
8. a b c d 32. a b c d 56. a b c d
9. a b c d 33. a b c d 57. a b c d
10. a b c d 34. a b c d 58. a b c d
11. a b c d 35. a b c d 59. a b c d
12. a b c d 36. a b c d 60. a b c d
13. a b c d 37. a b c d 61. a b c d
14. a b c d 38. a b c d 62. a b c d
15. a b c d 39. a b c d 63. a b c d
16. a b c d 40. a b c d 64. a b c d
17. a b c d 41. a b c d 65. a b c d
18. a b c d 42. a b c d 66. a b c d
19. a b c d 43. a b c d 67. a b c d
20. a b c d 44. a b c d 68. a b c d
21. a b c d 45. a b c d 69. a b c d
22. a b c d 46. a b c d 70. a b c d
23. a b c d 47. a b c d
24. a b c d 48. a b c d
87
6. As you bathe Mrs. Sweeney, she complains of an

Exam 5 ache or sore spot in her calf. You should
a. massage her legs with lotion.
1. Nursing orders frequently instruct you to “assist b. stop the bath and ask the nurse to check the
patient to cough and deep breathe.” This activity ache.
helps the patient avoid c. tell Mrs. Sweeney to get up and walk to relieve
a. decubitus ulcers. the cramping.
b. pneumonia. d. continue the bath and report the complaint to
c. internal bleeding. the nurse later.
d. dyspnea.
7. An example of contamination through indirect
2. What position should a patient be in to receive contact is
an enema? a. bathing the resident.
a. supine b. touching instruments or linens the resident
b. Fowler’s has used.
c. prone c. the resident sneezing or coughing on you.
d. left Sim’s d. all of the above
3. Which of the following lists only items that 8. As you walk down the hall, you hear a scream
would be included in fluid intake? and find smoke and flames coming from Mr.
a. milk, ham sandwich, ice cream bar Smith’s room. You should
b. water, mashed potatoes, gelatin a. attempt to get the resident out of the room if
c. milk, custard, soup possible and close the door.
d. orange juice, soft-boiled egg, toast b. throw water on the flames.
c. take Mr. Smith’s cigarettes away.
4. The nurse aide must use a stethoscope to deter- d. run to the telephone and call the fire depart-
mine the ment.
a. apical pulse rate.
b. carotid pulse rate. 9. Placing a client in good alignment means you
c. popliteal pulse rate. should
d. brachial pulse rate. a. keep his joints lubricated.
b. keep him as straight as possible.
5. Another name for urination is c. keep him sitting up during the day.
a. defecation. d. make sure he stands at least five hours per day.
b. voiding.
c. wetting the bed. 10. When using a cane or walker, the resident’s
d. flatus. 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.
89
11. Which of the following conditions needs to be 16. After positioning a client, it is MOST impor-
reported immediately to the charge nurse? tant to
a. rash that appears suddenly a. examine the client thoroughly.
b. warm, dry, and pink skin b. close the door to the client’s room so she can
c. tough skin on the feet rest.
d. scarred skin c. offer the client a drink of juice.
d. check the position of nonfunctional limbs.
12. To prevent a client from getting decubitis, it is
necessary to 17. As you are transferring a client, the client
a. wash urine and feces off with only water. becomes weak and starts to fall. Your FIRST
b. put baby powder on the skin to keep it dry. action would be to
c. rub the reddened area once a day. a. hold the client’s transfer belt and lean away
d. turn the client every 2 hours. from the fall.
b. call for help.
13. Mr. Brook has a broken hip and needs to have an c. grasp the transfer belt and lower the client to
enema. The best type of bedpan to use would be a the floor along your bent leg.
a. fracture pan. d. hold the client tightly and lean backwards.
b. plastic pan.
c. child-sized pan. 18. Accurate daily weights are measured
d. metal pan. a. at the same time each day.
b. with the client fully clothed.
14. Which of the following is true regarding visually c. in the morning.
challenged clients? d. all of the above
a. Clients use a “clock” system to locate food.
b. Clients usually prefer to eat alone. 19. The MOST important factor in preventing the
c. Clients prefer to be fed to prevent spills. spread of infection is to
d. All of the above are true. a. place the client in isolation.
b. wash hands between client contacts.
15. Before you ambulate a client who has a Foley c. clean the unit each day.
catheter, the FIRST action would be to d. wear sterile gloves to care for all clients.
a. clamp off the catheter and disconnect it, since
the bag would be in the way. 20. The purpose of the cleansing bath is to
b. leave the catheter dangling between the a. provide cleanliness.
client’s legs. b. promote circulation.
c. carry the bag below the level of the bladder. c. observe skin condition.
d. hide the bag in a pillowcase so the client will d. all of the above
not be embarrassed.
90
21. OSHA rules require all healthcare workers to be 26. If a resident begins to choke while being fed and
offered immunization against is unable to speak, the nurse aide should call for
a. hepatitis B. help and begin doing
b. hepatitis A. a. back blows.
c. hepatitis C. b. mouth-to-mouth ventilations.
d. AIDS. c. a finger sweep.
d. abdominal thrusts.
22. When a client is placed on I and O after surgery,
this means that you must 27. When you make a bed, you should place the
a. measure only the first voiding after surgery. soiled linen
b. record the color of the client’s urine. a. on the bedside table.
c. record all fluid intake and output. b. on the overbed table.
d. record the first solid food the client eats. c. in a laundry bag.
d. on a chair.
23. Mr. Johnson has not had a bowel movement for
five days. He might complain of 28. You have come upon a patient lying on the floor
a. abdominal cramping. who is not moving. Your first action should be to
b. lack of appetite. a. call for help.
c. slight nausea. b. gently shake the victim and ask, “Are you all
d. all of the above right?”
c. check to see if the patient is breathing.
24. Mr. Kull is weak and unsteady. He needs to uri- d. check to see if the patient has a pulse.
nate. You could safely leave him alone to use
a. a bedside commode. 29. If a client is receiving forced-fluid treatment, you
b. the toilet. should
c. a bedpan. a. provide at least 2,000 cc of fluid per shift.
d. a urinal. b. provide high-protein fluids.
c. offer liquids every hour.
25. For a client who is classified as wound-and-skin d. all of the above
isolation, the soiled linen should be
a. placed in the linen hamper. 30. When a client complains that his hearing aid is
b. discarded. hurting, you should
c. bagged before removing from the room. a. encourage him to leave the hearing aid in.
d. taken directly to the laundry. 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 36. The Patient’s Bill of Rights is
a. keeping them in a tissue in a dresser drawer. a. A verbal agreement given to those receiving
b. placing them in a labeled denture cup. healthcare.
c. insisting the client wear the dentures. b. A list of requests that patients submit when
d. placing an identifying mark on the dentures. admitted to a healthcare facility.
c. A written statement of rights entitled to those
32. A client who is too large for staff members to receiving healthcare.
transfer safely is d. A bill for their stay at a healthcare institution.
a. moved with a mechanical lifting device.
b. placed on a calorie-controlled diet. 37. When giving daily care, you should observe all
c. left in bed, but turned every two hours. clients for
d. left in bed, but repositioned every hour. a. general appearance.
b. mental condition.
33. Mr. Jones drinks five ounces of juice. You would c. skin condition.
record this as d. all of the above
a. 500 cc.
b. 150 cc. 38. When should you wash your hands?
c. 6 cc. a. after going to the bathroom
d. 5 cc. b. before and after each client contact
c. before eating
34. Mr. Smith has just had a cup of hot tea. You need d. all of the above
to take his temperature. You should
a. take a rectal temperature. 39. While bathing a resident, you notice a rash on
b. take an oral temperature immediately. both of her legs. You should
c. wait 15–20 minutes and then take an oral a. ignore the rash if the resident hasn’t com-
temperature. plained about it.
d. give him some cold water, and then take an b. scrub the rash to see if it disappears after the
oral temperature. bath.
c. notify the charge nurse at once.
35. Which of the following vital signs should be d. put alcohol on the rash to dry it out.
reported immediately?
a. T–98.6, P–70, R–14, BP–120/60 40. Nurse aides should report the care given to resi-
b. T–95.4, P–40, R–10, BP–80/40 dents by
c. T–98.8 “R,” P–60, R–20, BP–132/70 a. telling the charge nurse directly.
d. T–97.6 “ax”, P–78, R–16, BP–110/60 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 47. Which statement about dressing residents is
while you are bathing him. You should correct?
a. hold him down so he doesn’t fall out of bed. a. Dressing is a waste of time for a handicapped
b. shove the washcloth into his mouth. resident.
c. protect him from injuring himself. b. Residents are used to dressing in front of
d. run and get help. others.
c. Residents care about what they wear.
42. Body mechanics means d. Residents like the nurse aide to dress them.
a. the way the body parts are aligned with each
other. 48. A mentally ill resident is likely to
b. always using a transfer belt. a. believe she is someone other than herself.
c. using the body in a safe and efficient manner. b. be fearful, without good reason.
d. all of the above c. live in her own world.
d. all of the above
43. To change your direction, you should
a. turn your whole body by moving your feet. 49. Reality orientation techniques include
b. twist from the waist. a. labeling items in the resident’s room.
c. move your body in sections. b. putting up calendars and clocks.
d. move very slowly. c. using familiar items in the resident’s room.
d. all of the above
44. To turn the client toward you, you should
a. cross his far leg over the leg nearest you. 50. Jane is a 24-year-old resident with muscular dys-
b. cross his near arm over his chest. trophy. She has a supportive family, but she talks
c. bend his far arm at the elbow. often of her desire to have a boyfriend. This feel-
d. grab his shoulders and pull him toward you. ing is best described as
a. normal
45. To help a client into a wheelchair, the nurse aide b. foolish
should position the chair c. both a and b
a. at the side of the bed, facing the head of the d. hopeless
bed.
b. at the foot of the bed. 51. Rhonda, an 18-year-old, is a resident admitted
c. at the head of the bed. for long-term rehabilitation. She tells you she
d. at the side of the bed, facing the foot of wants to attend the local community college.
the bed. This seems
a. appropriate for her age.
46. To transfer a resident correctly from the bed to a b. a waste of time.
stretcher, you MUST c. an excuse to leave the facility.
a. use good body mechanics. d. a waste of money.
b. use a Hoyer lift.
c. have the help of seven coworkers.
d. raise the side rail on the stretcher first.
93
52. Two residents have decided to become a couple. 57. A client is hard of hearing and repeatedly turns
They may her call light on. The nurse aide should
a. hold hands. a. take time to listen to her to determine her
b. spend a lot of time together. needs.
c. insist on eating together. b. talk loudly to her since she is hard of hearing.
d. all of the above c. unplug the call light.
d. tell the supervisor that the client is uncooper-
53. Which statement about bathing for unconscious ative.
clients is correct?
a. Unconscious clients may be able to hear you 58. If you are giving a client a tub or shower bath,
speaking to them during the bath. you should
b. Unconscious clients can turn in bed when a. ensure the client’s privacy.
asked. b. check the water temperature.
c. Unconscious clients do not need to be c. gather all supplies before beginning.
observed for decubiti. d. all of the above
d. Unconscious clients have very moist skin.
59. A client who is eating poorly should be offered
54. Mr. Dobbs wants to know what kind of surgery a. vitamin pills.
his roommate is going to have the next day. The b. tube feeding.
best response by the nurse aide is c. clear broth.
a. “It really should not be any concern of yours.” d. dietary supplements.
b. “I’ll speak to the surgeon and find out.”
c. “I cannot share that information with you.” 60. The nurse aide is encouraged to attend resident
d. “You can call the OR and ask yourself.” council meetings if
a. invited to attend.
55. The best and most effective form of communica- b. the superior assigns you to attend.
tion is c. interested in what the residents are discussing.
a. written communication. d. none of the above
b. face-to-face communication.
c. telecommunication. 61. It is Good Friday and a Catholic client was
d. third-party communication. served chicken and requests a meatless meal. The
nurse aide should
56. A ten-month-old infant cries and pulls at his left a. offer to get another meal within the client’s
ear. You should diet.
a. check the baby’s diaper. b. call the bishop for a dispensation.
b. report this to the charge nurse. c. tell them that is all right since they are in the
c. cuddle or rock the baby. hospital.
d. all of the above d. tell them the aide will check with the dietician
for the next day’s meal.
94
– CHAPTER TITLE
62. A client is observing the Islamic Holy Month of 67. A resident refuses to go to physical therapy one
Ramadan by fasting from sunup to sundown. morning. The nurse aide reports this to the
The most appropriate action for the nurse aide charge nurse, who discusses this with the resi-
would be to dent. The resident states that she will go to phys-
a. tell her that all clients have to eat at the same ical therapy the next day. The nurse aide
time. understands that the resident
b. check with the doctor. a. has the right to refuse treatment.
c. find out when she may eat or drink. b. should not be given choices in his therapy.
d. both b and c c. does not have the right to refuse therapy.
d. could refuse therapy only with the doctor’s
63. An ECF resident tells the nurse aide something permission.
in confidence about her family. The nurse aide
a. can tell any staff member. 68. A person admitted to a hospital or extended-care
b. ethically cannot tell anyone else. facility can be expected to be treated according
c. can tell the charge nurse only. to the
d. can tell anyone who does not know the resident. a. State Hospital Association.
b. Caregiver’s Bill of Rights.
64. A nurse aide observes a client fall in the hallway. c. Patient’s Bill of Rights.
It is important to report d. Physician’s Association.
a. what she or he thinks happened.
b. exactly what was observed. 69. The nurse aide is told to bring a client by wheel-
c. nothing if she or he chooses. chair to the X-ray Department and covers the
d. all of the above client with a robe, blanket, and slippers. The
nurse aide has maintained the client’s
65. Which of the following behaviors may the client a. right to confidentiality.
consider caring? b. right to privacy.
a. making the client comfortable c. right to nursing-care plans.
b. getting the work done before lunch d. right to refuse.
c. showing interest in answering questions
d. a and c only 70. Nurse aides need to identify themselves with
their names and title of CNA before giving any
66. Mrs. Farber is an 88-year-old resident on your care to clients. This is an example of the patient’s
floor. She has cared for herself and her husband right to
until recently when he passed away. The nurse a. considerate and respectful care.
aide recognizes that Mrs. Farber needs to b. privacy.
a. be involved in planning her own care as much c. identification of healthcare workers.
as possible. d. be informed of hospital policies.
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.
95
– CHAPTER TITLE

Exam 5 remains below the bladder level. Choice c is
1. b. Coughing and deep breathing forces lower- correct.
lung movement.
16. d. A client may be lying on a nonfunctional limb
2. d. The correct answer is left Sim’s. This allows and have no awareness of it.
better irrigation of the colon.
17. c. Grasp the transfer belt and lower the resident
3. c. Only choice c lists liquids only. to the floor along your bent leg.
4. a. Only a stethoscope can “hear” the apical pulse. 18. a. Weight may fluctuate during the day, so to be
accurate you must weigh clients at the same
5. b. Voiding means urinating.
time each day.
6. b. Always report patient complaints to the nurse
19. b. The most important factor in preventing the
as soon as possible.
spread of infection is to wash your hands
7. b. The germs from the resident are on the soiled between client contacts.
instruments and stay there until they are
20. d. A bath correctly given promotes circulation at
washed and sterilized. Wear gloves when
the same time as it provides an excellent
washing dirty equipment.
opportunity to observe the skin.
8. a. Always try to rescue the victim first if possible;
21. a. OSHA rules require all healthcare workers be
then call the fire department.
offered immunization for hepatitis B.
9. b. Body alignment promotes circulatory status
22. c. I and O includes any liquid entering or leaving
and prevents contractions.
the body.
10. b. This position will create a balance between the
23. d. Lack of peristalsis causes all of these symp-
resident and the walker to prevent a fall.
toms and must be documented and reported.
11. a. Of the answers listed, only a is an acute
24. c. Keep the client in bed to prevent a fall, but
change.
allow privacy while voiding.
12. d. Turning the client is the best way to protect
25. a. Wound-and-skin isolation means high likeli-
against bedsores.
hood of linen contamination, but according
13. a. Choose a fracture pan so Mr. Brook will have to Standard Precautions, all linen is consid-
a minimal distance to lift his hips. ered potentially infective.
14. a. Most blind patients can feed themselves in a 26. d. Abdominal thrusts are always the first step for
dining-room setting if they can visualize their airway obstructions.
food on a plate. A clock system allows them to
27. c. Soiled linen should be directly placed in laun-
do this.
dry bags to prevent contamination.
15. c. You cannot disconnect the bag without an
28. b. Determine that there is a problem before call-
order, but you still must ensure that the bag
ing for help.
96
29. c. Choice a is incorrect because the doctor 44. a. This will promote motion and help you move
should specify the amount of liquid. Choice b the patient.
is incorrect because a force-fluid diet is differ-
45. d. Proximity of the bed to the chair will allow
ent from high-protein fluids. Choice d cannot
easier client transfer and the client will be fac-
be correct if a and b are incorrect.
ing the front of the room.
30. b. Always bring such complaints to the charge
46. a. Body mechanics promote good musculoskele-
nurse.
tal alignment.
31. b. Every resident with dentures must have a
47. c. Self-esteem promotes wellness. We all want to
labeled denture cup to ensure security of the
look nice and care about our personal appear-
costly dentures.
ance.
32. a. Use a mechanical device to protect both the
48. d. Thought processes of the mentally ill may
client and the staff.
include delusions and irrational fear.
33. b. One ounce is 30 cc, so 5 ounces is 5 × 30 or
49. d. These aids assist the resident to know where
150 cc.
his room is and what date it is.
34. c. Drinking hot liquids may cause an abnormal
50. a. All patients need to feel wanted and to share
reading on the thermometer.
their feelings with another person. This is
35. b. This patient’s vital signs are all very low. normal behavior.
36. c. The Patient’s Bill of Rights is a written state- 51. a. Rhonda wants to continue her education and
ment of the rights that patients are entitled to socialize with people her own age.
when receiving healthcare.
52. d. Relationships are common in a nursing home
37. d. All observations are important in healthcare. and allow both individuals to feel needed and
desirable.
38. d. Standard precautions include washing your
hands before and after patient contacts. 53. a. The last sense to leave is hearing. Speak with
kindness and be aware of what you say.
39. c. Any abnormality must be reported as soon as
possible. 54. c. The response reflects confidentiality for all
clients as well as an appropriate, nonoffensive
40. a. Reporting to the charge nurse or chain of
response to the roommate.
command is in the role of the nurse aide as
part of the health team. 55. b. Face-to-face communication is the most direct
with the least chance for misinterpretation.
41. c. Do not restrain the patient. Move all furniture
and equipment away to protect him from 56. d. Crying indicates the infant needs attention;
injury. pulling at the ear could indicate an ear infec-
tion. Check or do all of the above.
42. c. Good body mechanics ensure safety for both
the healthcare worker and the patient. 57. a. Listening carefully to the client’s needs
encourages communication and builds trust.
43. a. Moving the whole body prevents twisting the
back muscles and an injury. 58. d. All of the responses given are correct.
97
59. d. Dietary supplements are high in the necessary 65. d. Choices a and c are correct because comfort-
vitamins and minerals. ing and interest or time to answer questions
are behaviors that suggest caring. Choice b is
60. a. The resident council is a meeting of the resi-
incorrect because just getting work done is a
dents, and no staff may attend unless invited.
fact or neutral behavior.
61. a. It is important to accommodate religious
66. b. Residents have a right to be alone to grieve
needs of the client.
after the death of a loved one.
62. c. It is important to accommodate cultural
67. a. Residents can refuse treatment because of the
needs of the client; however, some patients’
Patient’s Bill of Rights.
health may become severely compromised if
they do not eat for many hours. Islam gener- 68. c. All clients are treated according to the
ally allows exemptions in medical cases, so Patient’s Bill of Rights.
you should check with the doctor to confirm
69. b. All clients have the right to privacy and should
that the client’s health will not suffer as a
be properly covered at all times.
result of fasting.
70. c. The right to know the identity of physicians,
63. b. Anything told in confidence cannot be
nurses, and others involved in their care.
revealed.
64. b. All incidents need to be described exactly as
observed.
98
C H A P T E R
Nursing
8 Assistant/Nurse
Aide Practical
Skills Exam
CHAPTER SUMMARY
For 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.
O NE TREND IN 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.
99
– NURSING ASSISTANT/NURSE AIDE PRACTICAL SKILLS EXAM –
Identification of client and explanation of procedures

Sample Task: Vital Signs ■ Use of correct language level for client compre-
hension
Instructions to Participant: ■ Content of explanation
1. Using the necessary equipment and procedures,
inform the client what you are doing. Questioning of client
■ Audible questioning
2. Take and record the following:
■ Questioned about: eating, drinking, smoking,
■ Oral temperature
■ Radial pulse physical activity

■ Respiration rate
Procedure to obtain oral temperature
■ Weight ■ Mercury: Holds thermometer correctly and starts
initial reading at 96 degrees or lower

OR
Vital Signs Worksheet ■ Digital: Applies probe cover
■ Correct placement in mouth under tongue
Client’s Number: ■ Length of time in mouth (at least 3 minutes)
Age: Gender: Reading/recording of oral temperature

■ Reads thermometer and records temperature
Oral Temperature:
within ±0.2 degrees of examiner’s reading
■ Mercury: Rinses thermometer
Radial Pulse:
OR
Respiration Rate: ■ Digital: throws away probe cover
■ Returns thermometer to storage

Weight:
Procedure to obtain radial pulse
Recorded by: ■ Choice of proper site
■ Pulse regularity
Signature:
■ Pulse assessment time
Evaluation Criteria Taking/recording of radial pulse

Hand washing ■ Rate ±2 beats
■ Make sure paper towels are within reach
■ Rate, rhythm, volume recorded
■ Turn on water at sink
■ Wet hands and wrists

Procedure to obtain respiration
■ Respiration rate and character
■ Apply soap
■ Respiratory assessment time (one minute)
■ Rub hands, wrists, and fingers for at least ten seconds
■ Records respiration ±2 breaths
■ Rinse thoroughly
■ Dry with paper towel thoroughly Taking/recording of weight

■ Use paper towel to turn off faucet ■ Scale correctly balanced or registering at zero
■ Dispose of paper towel into wastebasket without weight

■ Scale placed on a hard surface
Entry into the room and identification of self
■ Assists patient to step on the scale
■ Appropriate signal before entry into room
■ Reports and records weight within ±1 pound of
■ Identification of self to client
examiner’s reading
100
Evaluation Criteria
Sample Task: Wheelchair Use Hand washing
Estimated Completion Time: 20 minutes ■ Turn on water at sink
Instructions to Participant ■ Apply soap
1. Using the proper equipment, supplies, and tech- ■ Rub hands, wrists, and fingers for at least ten
niques, complete the following: seconds

A. Transfer a client with left-side hemiplegia ■ Rinse thoroughly
from a bed to a wheelchair. ■ Dry with paper towel thoroughly
B. Push the wheelchair along a hallway. ■ Use paper towel to turn off faucet
C. Demonstrate how to get in and out of an ele- ■ Dispose of paper towel into wastebasket
vator.
D. Transfer the client from the wheelchair to Entry into the room and identification of self
the bed.
2. When you have completed this procedure,
inform the evaluator. Identification of client and explanation of procedures
■ Use of correct language level for client compre-
Instructions to Evaluator hension

The participant will demonstrate transferring a client ■ Content of explanation
from bed to wheelchair. The client will be wheeled

down the hall and into and out of an elevator and Preparation of wheelchair
■ Places bed in appropriate and safest position for
returned to bed.
client
■ Positions wheelchair next to bed
Provide the following:
■ Folds up footrests and locks brakes
Hospital bed
Call bell Assisting client to sitting position
Chart ■ Supports client and assists to sitting position with
Transfer belt (optional) feet flat on the floor

Wheelchair ■ Applies transfer belt (optional)
Lap robe ■ Makes sure resident has nonskid footwear on
Blanket
Assisting client to standing position
Slippers
■ Uses body mechanics for lifting
Client with left-side hemiplegia and name
■ Signals as transfer of client begins to standing
bracelet
position
Hand soap
■ Observes client as needed
Sink
Paper towels Assisting client into wheelchair
Elevator simulation (doorway with raised ■ Pivots feet to turn to client
elevation) ■ Gently lowers client safely into the wheelchair
101
Client comfort and security in chair Sample Task: Measuring and

■ Removes transfer belt
Recording Urinar y Output
■ Adjusts client
■ Adjusts footrests
Evaluation Criteria
■ Gives client signaling device
Hand washing
■ Washes hands ■ Make sure paper towels are within reach

Wheelchair operation
■ Apply soap
■ Releases brakes
■ Rub hands, wrists, and fingers for at least ten
■ Stays to right of hallway (if applicable)
■ Enters and exits elevator by pulling backwards

seconds
■ Returns to room
■ Dry with paper towel thoroughly
Return of client to bed ■ Use paper towel to turn off faucet

■ Placed chair on client’s unaffected side of bed
■ Dispose of paper towel into wastebasket
■ Applied brakes
■ Applied transfer belt (if applicable)

Measuring urine content
■ Puts on gloves
■ Moved footrests out of way
■ Pours contents of urine from bedpan into meas-
■ Used proper body mechanics to lift, pivot, and
return patient to bed uring container without spilling or splashing

■ Keeps the container level
Client comfort and security in bed

■ Proper body alignment
Cleaning the container and bedpan
■ Empties the container into the toilet cleanly
■ Call belt in place (if applicable)
■ Cleans container with water; pours water into
■ Side rails up
toilet
Storage of wheelchair and other items ■ Cleans bedpan with water; pours water into toilet
■ Folding and placement of chair in proper loca-
■ Stores container and bedpan
tion
Recording urine output
Hand washing ■ Removes disposable gloves
■ Washes hands
■ Records content ± 25 ccs/mls of examiner’s
■ Apply soap
reading
■ Rub hands, wrists, and fingers for at least ten sec-
onds
■ Use paper towel to turn off faucet
102
Sample Task: Positions Client Identification of client and explanation of procedures

on Side ■ Use of correct language level for client compre-
hension
■ Content of explanation
Evaluation Criteria
Hand washing Turning the client
■ Makes sure client has privacy
■ Turn on water at sink
■ Lowers head of bed
■ Moves client’s body towards self
■ Apply soap
■ Raises side rail of bed
■ Rub hands, wrists, and fingers for at least ten sec-
■ Supports client’s body and turns towards raised
onds side rail
■ Adjusts client’s body properly
■ Covers client with bedding
■ Use paper towel to turn off faucet
■ Gives client signaling device
■ Leaves bed in lowest position
■ Washes hands
Entry into the room and identification of self
103
C H A P T E R
Certification
9 Requirements
and Trends
CHAPTER SUMMARY
This 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.
T HERE IS NO 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 Certification and Training
Since OBRA (Omnibus Budget and Reform Act) was passed in 1987, the Federal Government has been setting
regulations and creating standards for the quality of nursing-home care. Specific guidelines and standards were
prescribed—one major change was the training and testing of nursing assistants/nurse aides. In many states, 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
105
– CERTIFICATION REQUIREMENTS AND TRENDS –
is 80. Some states have created their own standards 3. Communication

for nursing assistants. These standards include the Medical Terminology
minimum training requirements as well as a written Observations
exam of multiple-choice questions and clinical/ Vital Signs
practical skills evaluation. Most healthcare facilities Height & Weights
now require that nurse aides have a high school 4. Personal Care: Hygiene, Bathing, Grooming
diploma or GED and pass a state-approved program. Oral Care, Foot Care, Skin Care, Decubitus Pre-
Nurse aides completing these programs must obtain vention
certification within four months of being hired at a Infection Control
healthcare facility. Once you pass the written exam, 5. Gastrointestinal & Urinary Systems
you will be placed on your state’s registry for Nurse Nutrition
Aides—your certification is then valid for 24 months. Fluids, Intake & Output
After being certified, CNAs are usually required to earn 6. Rehabilitation & Restorative Concepts
continuing-education credits, usually through in- Prosthesis
service training. Specimen Collection
Common Health Problems
Training Programs 7. Human Immunodeficiency Virus and AIDS
In New York State, 120 hours of training are required 8. Blood Borne Pathogens: Hepatitis B & C, HIV
and a person must pass his or her clinical exam before Death and Dying
taking the written (or oral) exam. Washington State 9. Cardiopulmonary Resuscitation and the
requires 85 hours of training in a state-approved NA Heimlich Maneuver
program along with at least seven hours of training in 10. Understanding & Managing Difficult Behavior
HIV and AIDS. Dementia Care
In any states that require the certification of Preparation for Final & Competency Exam
nursing assistants, the training program is likely to be Source: Nursing Assistant Training Institute, http://
similar to the samples shown on the following pages. nursingassistanttraining.homestead.com
The following are sample classes from a nurse aide
training course given by the Nursing Assistant Training Pennsylvania requires a minimum of 75 hours of
Institute in Shoreline, Washington. The classes consist training—37.5 hours of theory and 37.5 hours of clin-
of 40 hours of training, in addition to 12 hours of ical. Training programs throughout the state do
hands-on skills practice and demonstration, and 50 vary—the Institute for Caregiver Education in Cham-
hours of clinical experience. bersburg, Pennsylvania, has a four-week, 140-hour
nurse assistant training program. Topics covered
1. Role of the Nursing Assistant include:
Rules and Regulations Governing Care
Understanding Your Resident Week 1: (35 hours)
A. Communication
Physical and Psychosocial Aging Changes
B. Work Ethic
2. Safety/Fire and Disaster C. Getting Along with Supervisors and
Body Mechanics Coworkers
Transferring, Positioning, Ambulation D. Attitude
Restraints: The Last Resort E. Customer Service
F. Stress Management
106
G. Time Management often affiliate with a healthcare facility. Then the course
H. Problem Solving work is given in the school and the clinical work is per-
I. Conflict Resolution formed in the healthcare facility or in a home setting
J. Teamwork served by a healthcare agency.
K. Aging Sensitivity
In the states that require certification, there are
L. Special Needs Clients
M. Managing Difficult Clients usually a large number of locations that offer training
programs. In Illinois, for example, there are some 300
Weeks 2–4: (105 hours)
approved CNA training programs. Agencies that offer
A. Role and Function of the Nursing Assistant
training programs often hire the people they have
B. Infection Control
C. Residents’ Rights trained, so they are good places to sign up for a train-
D. Nutrition and Special Diets ing program that may lead to a job offer when you
E. Personal Care Skills complete the course.
F. Bedmaking
G. Transferring and Ambulating
H. Death and Dying Exams
I. Post-Mortem Care
J. Toileting and I & Os
K. Aging Process—Review of Systems Training programs usually conclude with a written (or
L. Vital Signs oral) examination that determines whether the student
M. Data Collection and Observation Skills is qualified to receive certification. Some institutions
N. Rehab and Restorative Care that offer training make up their own examinations,
O. Catheter Care while others may use an exam prepared by a company
P. Resident Assignments (beginning with one that specializes in developing tests. Tests typically range
and working up to four residents per stu-
from 50 to 150 questions and are in sections that relate
dent)
Q. Debriefing and Skills Review (after each day directly to the subject areas covered in the training,
of clinical experience) such as patient-care procedures, emergency proce-
Source: The Institute for Caregiver Education, www. dures, or observation and charting. Usually a candidate
caregivereducation.org must achieve a passing grade in each of the sections,
and not just overall, in order to qualify for certification.
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- Why Certification?
cise, or use the bathroom. The clinical part of the
training programs help to determine if a student is The main reason behind the trend to CNA certification
capable of performing these tasks. is the growth of home healthcare. Home-based health-
Training programs are given in a number of set- care has been on the increase because of cost-saving
tings, including both public and private vocational- measures in the health industry: Patients are being
technical schools, community colleges, public-health encouraged to leave relatively expensive hospital-based
agencies, and for-profit and not-for-profit healthcare care to complete their recuperations in lower-cost
agencies, such as Visiting Nurse Associations. Since alternative settings, including short-term and long-
hands-on clinical experience is usually required, term care facilities, as well as the home. Nursing assis-
schools that do not have their own healthcare services tants work in a wide variety of healthcare settings,
107
including skilled-nursing facilities, doctors’ offices, Combining CNA and Home

hospices, board-and-care retirement facilities, acute- Health Aide Certification
care hospitals, clinics, rehabilitation hospitals, psychi-
atric hospitals, facilities for the developmentally The trend to certification is also spurred by the fact
disabled, and daycare facilities. But the delivery of that the training programs for nursing assistants typ-
services in patient homes is what has increased aware- ically include the training requirements for the job
ness of state and national authorities, leading to the of home health aide (HHA), as well. HHA training
increase of requirements for certification. follows a federally mandated 75-hour curriculum.
Certification offers assurance that nursing assis- The federal mandate is there because home-healthcare
tants, who have such immediate, important, and inti- agencies are eligible for Medicare funds for the services
mate contact with elderly or disabled persons, have they provide to the elderly.
been properly trained to deal with the many and var- Since CNAs can perform medical tasks beyond
ied tasks they will have to perform. This is very impor- what HHAs are trained to do, someone who has train-
tant to the healthcare agencies that the CNAs work for, ing and certification in both job categories is obviously
as well as to the families of the patients. The federal of greater value to the agency doing the hiring. The
government, which is often the funding source for employer is better off hiring one person who can per-
home healthcare under the Medicare program, also form the work of two persons, even if that one person’s
wants to know that its funds are being spent for high- salary is a little higher than that of a person with one
quality services. certification.
A representative of one major home-healthcare
agency in Austin, Texas, reported that the Sunday
Emphasis on Interpersonal newspaper usually contains almost a full page of ads
Skills from home-healthcare agencies calling for people to
work as home health aides. However, she noted that
While it has always been important for healthcare pro- most of these ads want CNAs to fill these positions
fessionals of all kinds to be able to make patients feel because they have skills that go beyond those required
safe and comfortable, these skills become even more of a home health aide.
crucial when care is being delivered in the patient’s The home health aide profession is growing
own home or in long-term care. Thus, many training faster than average and should continue growing
programs are now emphasizing interpersonal skills through 2010. The reason for this is the increased need
more than ever before. In the sample training pro- for home care of the elderly—patients are being moved
grams shown earlier in this chapter, you can see inter- out of hospitals and nursing homes to lower healthcare
personal skills such as Understanding Your Resident in costs. In the year 2000, more than 600,000 people were
the first curriculum and Communication in the sec- employed as home health aides and most were
ond curriculum are emphasized and listed at the employed in home-health agencies, nursing facilities,
beginning of each program. 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 cessful completion of the CNA training and the pas-
works independently and with a variety of patients. sage of the written competency examination serves as
Supervisors visit sporadically, and the aide is always a dual certification for home health aides as well.
given explicit instructions pertaining to schedule and And in November 2001, the state of Washington
patient care. passed Initiative 775, founding a Home Care Qualita-
In Massachusetts, persons entering home health tive Authority that will “regulate and improve the qual-
aide programs are often encouraged to undergo dual ity of long-term in-home care services by recruiting,
training and become CNAs in order to improve their training, and stabilizing the workforce of individual
employment opportunities. providers.”
In some states, such as Illinois, people who want The good news for people who want to become
to become home health aides are required to take the nursing assistants is that the growth of healthcare in
same training program as CNAs. The HHA training is alternative settings ensures that workers will be
included within the program as part of the CNA train- needed. CNAs can look forward to good job prospects
ing. As a result, the certification that follows the suc- for the foreseeable future.
109
C H A P T E R
10 Important
Resources
CHAPTER SUMMARY
This chapter identifies numerous healthcare organizations and serv-
ices—potentially valuable resources in your search for the right job.
I F 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 Associations
Professional associations are made up of experts in the nursing field. Both members and the people who run these
organizations are actively working in, and on the behalf of, the fields they represent. Above all, they are great
sources of information on possible careers, education and training programs, and professional requirements such
as certification and licensure. In most cases, if these folks don’t have the information you need, they can tell you
who will.
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.
111
– IMPORTANT RESOURCES –
Many also sponsor seminars, workshops, and other Department of Health and Human Services
educational forums. All of these efforts can help inter- 200 Independence Avenue SW
Washington, DC 20201
ested individuals keep up on current happenings in a Phone: 202-619-0257
given field. Toll Free: 877-696-6775
www.os.dhhs.gov
Agency for Healthcare Research and Quality
2101 E. Jefferson Street, Suite 501 Home Care Aide Association of America
Rockville, MD 20852 228 7th Street SE
Phone: 301-594-1364 Washington, DC 20003
www.ahrq.gov Phone: 202-547-7424
Fax: 202-547-3540
American Association for Homecare
www.nahc.org/HCA/home.html
625 Slaters Lane, Suite 200
Alexandria, VA 22314-1171 Home Healthcare Nurses Association
Phone: 703-836-6263 228 7th Street SE
Fax: 703-836-6730 Washington, DC 20003
www.aahomecare.org Phone: 202-546-4754
www.hhna.org
American Association of Homes and Services for
the Aging Hospice Association of America
2519 Connecticut Avenue NW 228 7th Street SE
Washington, DC 20008-1520 Washington, DC 20003
Phone: 202-783-2242 Phone: 202-546-4759
Fax: 202-783-2255 Fax: 202-547-9559
www.aahsa.org www.hospice-america.org
American Healthcare Association Hospice Foundation of America
1201 L Street NW 2001 S Street NW, #300
Washington, DC 20005 Washington, DC 20009
Phone: 202-842-4444 Phone: 800-854-3402
Fax: 202-842-3860 Fax: 202-638-5312
www.ahca.org www.hospicefoundation.org
American Hospital Association (headquarters) National Association for Home Care*
One North Franklin 228 7th Street SE
Chicago, IL 60606 Washington, DC 20003
Phone: 312-422-3000 Phone: 202-547-7424
Fax: 312-422-4796 Fax: 202-547-3540
www.aha.org www.nahc.org
*affiliates include Home Care Aide Association of America,
American Medical Association
Home Healthcare Nurses Association, Hospice
515 North State Street
Association of America, and Hospital Home Care
Chicago, IL 60610
Association of America
Phone: 312-464-5000
www.ama-assn.org National Council on the Aging (NCOA)*
409 3rd Street SW
American Public Health Association
Suite 200
800 I Street NW
Washington, DC 20001-3710
Phone: 202-479-1200
Phone: 202-777-APHA
Fax: 202-479-0735
Fax: 202-777-2534
www.ncoa.org
www.apha.org
*geriatric care
112
National Rural Health Association Assisted Living and Extended Care Facilities,
One West Armour Boulevard, Suite 203 Hospital Blue Book, and Managed Healthcare
Kansas City, MO 64111-2087 Organizations
Phone: 816-756-3140 Billian’s HealthDATA Group
www.nrharural.org 2100 Powers Ferry Road
Atlanta, GA 30339
Phone: 770-955-8484
Fax: 770-955-8485
Directories www.billianshealthdata.com
(assorted directories on healthcare facilities, hospitals,
Consult the directories on the following list for . . . well, and managed-care organizations)
mostly more lists. Just like your local phone book, Case Management Resource Guide
these directories offer you long lists of names, AAHP/Dorland Directory of Health Plans
addresses, phone numbers, and contact persons—in Directory of Physician Groups & Networks
this case, at hospitals, HMOs, private practices, geri- Dorland Healthcare Information
1500 Walnut Street—Suite 1000
atric facilities, and more. Directories can be especially
Philadelphia, PA 19102
useful when you are researching education programs Phone: 215-875-1212
or scoping out job prospects in your region or across Toll Free: 800-784-2332
the country. Fax: 215-735-3966
Product Inquiries: info@dorlandhealth.com
AHA Guide to the Health Care Field www.Dorlandhealth.com
American Hospital Association (healthcare facilities, HMOs, adult daycare, cancer
One North Franklin, 27th Floor centers, other)
Chicago, IL 60606
Toll Free: 800-242-2626 Directory of Privately Owned Hospitals, Hospital
www.ahaonlinestore.com Management Companies and Health Systems,
(hospitals, clinics, other healthcare organizations) Residential Treatment Facilities and Centers, and
Key Management Personnel
American Association of Homes and Services for
the Aging Federation of American Hospitals
1405 North Pierce, Suite 311
2519 Connecticut Avenue NW
Little Rock, AR 72207
Washington, DC 20008-1520
Phone: 501-661-9555
Phone: 770-442-8633, ext 369
(healthcare facilities nationwide)
Toll Free: 800-508-9442
www.aahsa.org/public/books.htm American Hospital Directory
(assorted books on geriatric care) 3630-A Brownsboro Road, #200
Louisville, KY 40207-1861
American Medical Group Association
Fax: 502-899-7738
1422 Duke Street
www.ahd.com
Alexandria, VA 22314-3430
E-mail: inbox@ahd.com
Phone: 703-838-0033
(hospitals)
Fax: 703-548-1890
www.amga.org Medical and Health Information Directory
(assorted books on physicians–private medical practices)
Gale Research Company
P.O. Box 9187
Farmington Hills, MI 48333-9187
Phone: 800-877-GALE
Fax: 800-414-5043
www.galegroup.com
E-mail: galeord@gale.com
(medical associations, schools, federal agencies, other)
113
Placement Ser vices and Job CompHealth

4021 South 700 East, Suite 300
Searches Salt Lake City, UT 84107
Phone: 800-453-3030; 801-264-6400
Many organizations nationwide provide employment Fax: 801-264-6464
services for healthcare workers. In fact, it is a growing www.comphealth.com
field precisely because the number of jobs is grow- Department of Health and Human Services
ing so fast. The list below covers just a few of the 200 Independence Avenue SW
organizations and government agencies nationwide
Phone: 202-619-0257
working to identify available jobs in healthcare, link Toll Free: 877-696-6775
candidates to employers and vice versa, or aid in the For 24-hour Job Information: 912-757-3000
actual hiring process. www.hhs.gov/jobs
(federal jobs)
Tip: For those of you who are savvy with online
computer services, make the Internet and the World Department of Veterans Affairs
Wide Web part of your job-hunting process. Both pri- 810 Vermont Avenue NW
vate industry and government bureaus sponsor career- Phone: 202-273-5400
and employment-related websites. Virtually every www.va.gov
major “search engine,” such as Yahoo or AltaVista, (federal jobs)
offers a list of predesignated employment databases or Health Personnel Options
online classifieds to help you start your search. We have 8150 Corporate Park Drive, Suite 300
also included some pertinent website listings here. You Cincinnati, OH 45242
Phone: 513-936-3468
also can tap into bulletin boards and discussion groups
Toll Free: 877-936-4762
on the Internet that are frequented by healthcare pro- Fax: 513-891-6145
fessionals, where you can post your credentials, ask www.healthpersonnel.com
ever so politely for referrals, or respond to specific job (temporary assignments and temporary to permanent)
listings. NursingHands.com
www.NursingHands.com/CC/
American Association of
Managed Care Nurses, Inc. NursingJobs.com
Job Placement Services Phone: 877-435-2131
4435 Waterfront Drive, Suite 101 E-mail: info@nursingjobs.com
Glen Allen, VA 23060 www.nursingjobs.com
Phone: 804-527-1905
Fax: 804-747-5316 Nurse Web Search—The Nurse Directory
www.aamcn.org www.nursewebsearch.com/nursing_employment.htm
(provides listings of assorted websites for nurse-related
American Nursing Services issues, including employment)
Phone: 800-444-NURS (6877)
www.american-nurse.com NurseZone
12235 El Camino Real, Suite 200
American Public Health Association CareerMart San Diego, CA 92130
(online only) Phone: 877-585-5010
www.apha.org/career Fax: 888-458-0197
www.NurseZone.com
114
Homecare Organizations Carondelet Home Health

1120 South Swan Road
by State Tucson, AZ 85711
520-721-3822
One of your best bets in finding a job is one of the 520-512-0439 fax
more than 20,000 home-healthcare providers operat- ARKANSAS
ing in the United States as of 2000. The National Asso- Home Care Association of Arkansas
ciation for Home Care (NAHC) defines homecare 411 South Victory
Suite 205
organizations as home-health agencies, homecare-aide
Little Rock, AR 72201
organizations, and hospices. Types of homecare agen- 501-376-2273
cies include visiting-nurse associations (VNAs), pub- 501-376-7107 fax
lic (government) agencies, proprietary (for profit) Home Health Professionals
agencies, private not-for-profit agencies, and hospital- P.O. Box 704
based agencies. Blytheville, AR 72316
Members of the NAHC are featured in the state- 870-762-1825
870-762-2299 fax
by-state listing of homecare organizations below.
Arkansas Hospital Association
ALABAMA
419 Natural Resources Drive
Alabama Association of Home Health Agencies
Little Rock, AR 72205-1576
P.O. Box 40
501-224-7878
Montgomery, AL 36101
501-224-0519 fax
334-395-9949
www.arkhospitals.org
800-934-4312
334-832-1430 fax CALIFORNIA
California Association for Health Services
Medical Center Home Health
at Home
11491 US Highway 431
723 S Street
Albertville, AL 35950
Sacramento, CA 95814-7021
256-878-7022
916-443-8055
256-878-7067 fax
916-443-0652 fax
ALASKA www.cahsah.org
Alaska Home Care Association
Community Hospital Home Health Services/
Geneva Woods Home Health Care
Hospice of the Central Coast
501 West International Airport Road
555 Abrego Street
Suite 1A
Monterey, CA 93940
Anchorage, AK 99518
831-658-3901
907-565-6100
831-648-7741 fax
907-565-6112 fax
COLORADO
ARIZONA
Home Care Association of Colorado
Arizona Association for Home Care
7853 East Arapahoe Road
2334 South McClintock
Suite 2100
Tempe, AZ 85282
Englewood, CO 80112
480-967-2624
303-694-4728
480-966-0442 fax
303-694-4869 fax
www.hcaconline.org
115
Caring Plus Florida Hospital Association

420 West 29th Street 307 Park Lake Circle
Pueblo, CO 81008 Orlando, FL 32803
719-544-4197 407-841-6230
719-544-0657 fax 407-422-5948 fax
www.fha.org
CONNECTICUT
Connecticut Association for Home Care, Inc. GEORGIA
110 Barnes Road Georgia Association for Comprehensive Home
P.O. Box 90 Care, Inc.
Wallingford, CT 06492-0090 2100 Roswell Road
203-265-9931 Suite 200C - PMB 407
203-949-0031 fax Marietta, GA 30062
www.cthomecare.org 770-565-4531
770-565-1739 fax
VNA of Central Connecticut
205 West Main Street Georgia Association of Community Care
New Britain, CT 06052 Providers
860-224-7131 168 North Johnston Street
860-224-8303 fax Suite 304
Dallas, GA 30132
DELAWARE 770-445-6640
Delaware Association of Home Care and 770-445-3893 fax
Community Care
Veale Road Professional Center Georgia Home Care Association
309 Veale Road 168 North Johnston Street
Wilmington, DE 19810 Suite 304
302-529-3000 Dallas, GA 30132
302-529-3009 fax 770-445-3180
770-445-3893 fax
Delaware Hospice Association www.gahca.org
3515 Silverside Road
Suite 100 Nursing Care, Inc.
Wilmington, DE 19810 205 Boulevard NE
302-478-5707 Gainesville, GA 30501
800-838-9800 770-536-0484
302-479-2586 fax 770-536-3003 fax
FLORIDA HAWAII
Associated Home Health Industries of Florida, Home Care and Hospice Division,
Inc. Healthcare Association of Hawaii
512 North Calhoun Street 932 Ward Avenue
Tallahassee, FL 32301-2600 Suite 430
850-222-8967 Honolulu, HI 96814-2126
850-222-9251 fax 808-521-8961
www.ahhif.org 808-599-2879 fax
www.hah.org
Prime Care Health Agency
3900 NW 79th Avenue, #334 Castle Home Care
Miami, FL 33166 46-001 Kamehameha Highway
305-591-7774 Suite 201
305-594-8951 fax Kaneohe, HI 96744
808-247-2828
808-236-1337 fax
116
IDAHO IOWA
Idaho Association of Home Health Agencies Iowa Association for Home Care
P.O. Box 6508 1520 High Street, Suite 203-B
Boise, ID 83707 Des Moines, IA 50309
208-362-8190 515-282-3965
208-562-1366 fax 515-282-8034 fax
www.iowahomecare.org
Guardian Home Care
119 South Valley Drive Visiting Nurse Association
Suite C 2530 University
Nampa, ID 83686 Waterloo, IA 50701
208-461-1600 319-235-6201
319-232-7296 fax
ILLINOIS
Illinois Home Care Council Iowa Hospice Organization
1926 Waukegan Road 100 East Grant Avenue, Suite 120
Suite 1 Des Moines, IA 50309
Glenview, IL 60025 515-243-1046
847-657-6960 515-283-9358 fax
847-657-6963 fax
Hospice of North Iowa
Partners Home Care 232 Second Street, SE
2835 North Sheffield Avenue, #401 Mason City, IA 50401
Chicago, IL 60657 515-423-3508
773-549-5822 ext 150 515-424-7827 fax
773-549-9122 fax
KANSAS
VNA First Kansas Home Care Association
47 South Sixth Avenue, Suite 120 1512 B Legend Trail Drive
LaGrange, IL 60525 Lawrence, KS 66047
708-788-2047 785-841-8611
708-745-2920 fax 785-749-5414 fax
www.vnaf.org www.kshomecare.org
INDIANA Stormont Vail Home Health

VNS—Indianapolis 833 SouthWest Garfield Avenue
4701 North Keystone Avenue Topeka, KS 66604
Indianapolis, IN 46205 785-354-4300
317-722-8200 785-354-1058 fax
317-722-8250 fax
Association of Kansas Hospice
Indiana Association for Home and Hospice Care, 1901 University
Inc. Witchita, KS 67213
8604 Allisonville Road, Suite 260 316-263-6380
Indianapolis, IN 46250 316-263-6542 fax
317-844-6630
317-575-8751 fax
Hospice Services, Inc.
P.O. Box 116
www.ind-homecare.org
Phillipsburg, KS 67661-0116
Interim HealthCare of ECI 913-543-2900
1
2032 North Broadway 913-543-5688 fax
Greenfield, IN 46140
317-467-0787
317-467-0790 fax
117
LOUSIANA VNA of Southeastern Massachusetts

HomeCare Association of Louisiana 502 Bedford Street, 4th Floor
233-A East Main Street Fall River, MA 02720
New Iberia, LA 70562 508-676-8251
337-560-9610 508-646-4017 fax
337-560-9606 fax
Massachusetts Council for Home Care Aide
www.hcla2000.org
Services
Acadian Home Health 31 New Chardon Street
1340 Surrey Street Boston, MA 02114
Lafayette, LA 70501 617-227-6641
337-233-1307 617-227-1190 fax
318-235-8037 fax
Health Force/Medi Force
MAINE 60 Lowell Street
Home Care Alliance of Maine Arlington, MA 02174
20 Middle Street 781-641-2800
Augusta, ME 04330 781-646-3150 fax
207-623-0345
Visiting Nurses Association of New England
207-623-7141 fax
55 Charles Street
www.homecarealliance.org
Needham, MA 02194-2905
Kno-Wal-Lin Home Care 781-444-0713
170 Pleasant Street 781-449-6563 fax
Rockland, ME 04841
Community VNA of Attleborough
207-594-9561
141 Park Street
207-594-2527 fax
Attleborough, MA 02703
MARYLAND 508-222-0118
Maryland-National Capital Homecare 508-226-1012 fax
Association
MICHIGAN
625 Slaters Lane
Michigan Home Health Association
Suite 200
2140 University Park Drive, Suite 220
Alexandria, VA 22314
Okemos, MI 48864
703-535-1885
517-349-8089
703-519-9066 fax
517-349-8090 fax
Lauren Simpson www.mhha.org
Potomoc Home Health Care/Support
Henry Ford Extended Care
6001 Montrose Road, Suite 307
24445 Northwestern Highway, Suite 110
Rockville, MD 20852
Southfield, MI 48075
301-896-6998
248-352-4890
301-896-6275 fax
248-352-3224 fax
MASSACHUSETTS
MINNESOTA
Home & Health Care Association of
Minnesota HomeCare Association
Massachusetts
1711 West County Road B, Suite 211S
31 James Avenue, Suite 780
St. Paul, MN 55113-4036
Boston, MA 02116
651-635-0607
617-482-8830
651-635-0043 fax
617-426-0509 fax
www.mnhomecare.org
118
Perham Memorial Home Care MONTANA

665 Third Street, SW Montana Association of Home Health Agencies
Perham, MN 56573 1905 River Road
218-346-1190 Missoula, MT 59801
218-346-1237 fax 406-721-4035
406-721-4035 fax
MISSISSIPPI
www.mahha.org
Mississippi Association for Home Care
P.O. Box 1468 Flathead County Home Health Agency
Ridgeland, MS 39158-1468 711 East 13th Street
601-853-7533 Whitefish, MT 59937
601-853-7582 fax 406-862-9030
www.mahc.org 406-862-9025 fax
Gilbert Home Health Montana Hospital Association:

605 2nd Ave North, #203 An Association of Health Care Providers
Columbus, MS 39701 P.O. Box 5119
662-327-9669 Helena, MT 59604
662-239-2015 fax 406-442-1911
406-443-3894 fax
Mississippi Hospital Association
www.mtha.org
P.O. Box 16444
Jackson, MS 39236-6444 NEBRASKA
601-368-3220 Nebraska Association of Home and Community
601-368-3200 fax Health Agencies
www.mhanet.org 7421 Forbes Drive
Lincoln, NE 68516
North Mississippi Medical Center Home Care/
402-489-1117
Hospice Department
402-489-1117 fax
600 West Main Street
Tupelo, MS 38801 Good Samaritan Hospital Home Care Services
662-841-3611 10 East 31st Street
662-841-3990 fax Kearney, NE 68847
308-865-7090
MISSOURI
308-865-2923 fax
Missouri Alliance for Home Care
2420 Hyde Park Road, Suite A NEVADA
Jefferson City, MO 65109 Home Health Care Association of Nevada
573-634-7772 P.O. Box 186298
573-634-4374 fax Reno, NV 89511-0629
www.homecaremissouri.org 775-323-6003
775-853-2166 fax
John Knox Village Home Health
400 Northwest Murray Road Washoe Home Care
Lee’s Summit, MO 64081 780 Kuenzli
816-524-1133 Suite 200
816-524-9177 fax Reno, NV 89502
775-982-5877
Missouri Hospital Home Health Council
775-882-5795 fax
P.O. Box 60
Jefferson City, MO 65102
573-893-3700
573-893-2809 fax
119
NEW HAMPSHIRE Basin Home Health, Inc.

Home Care Association of New Hampshire 200 North Orchard
8 Green Street Farmington, NM 87401
Concord, NH 03301 505-325-8231
603-225-5597 505-325-4516 fax
603-225-5817 fax
NEW YORK
www.homecarenh.org
Home Care Association of New York State, Inc.
Home Health & Hospice Care 194 Washington Avenue, Suite 400
22 Prospect Street Albany, NY 12210
Nashua, NH 03060 518-426-8764
603-882-2941 518-426-8788 fax
603-883-1515 fax www.hcanys.org
NEW JERSEY Independence Care Systems, Inc.

Home Health Assembly of New Jersey, Inc. 257 Park Avenue South
14 Washington Road, Suite 211 New York, NY 10010
Princeton Junction, NJ 08550-1030 212-584-2580
609-275-6100 212-584-2555 fax
609-936-9349 fax
New York State Association of Health Care
www.homecarenj.org
Providers, Inc.
Patient Care, Inc. 90 State Street, Suite 200
100 Executive Drive, Suite 130 Albany, NY 12207
West Orange, NJ 07052 518-463-1118
973-669-5222 518-463-1606 fax
973-243-5901 fax www.nyshcp.org
Home Care Council of New Jersey New York Nursing Care

201 Bloomfield Avenue, Suite 3 527 Townline Road, Suite 302
Verona, NJ 07044 Hauppauge, NY 11788
973-857-3333 631-979-2200
973-857-1192 fax 631-979-2265 fax
Certified Health Aide of Somerset County Health Care Association of New York State
205 West Main Street One Empire Drive
Sommerville, NJ 08876 Rensselaer, NY 12144
908-725-5533 518-431-7600
908-725-5648 fax 518-431-7915 fax
www.hanys.org
New Jersey Hospital Association
760 Alexander Road Cayuga Medical Center at Ithaca
P.O. Box 1 101 Dates Drive
Princeton, NJ 08543-0001 Ithaca, NY 14850
609-275-4000 607-274-4443
609-275-4265 fax 607-274-4527 fax
www.njha.com
Hospice and Palliative Care Association
NEW MEXICO of New York State
New Mexico Association for Home Care 21 Aviation Road, Suite 9
3200 Carlisle Boulevard NE, Suite 117 Albany, NY 12205
Albuquerque, NM 87110 518-446-1483
505-889-4556 518-446-1484 fax
505-889-4928 fax www.hpcanys.org
www.nmahc.org
120
Hospice of Central New York Midwest Home Health Care

990 Seventh North Street 1711 South University Drive
Liverpool, NY 13088-6148 Fargo, ND 58103
315-634-2181 701-280-2802
315-634-1111 701-280-4030 fax
Home Care Council of New York City OHIO

25 West 43rd Street, 3rd Floor Ohio Council for Home Care
New York, NY 10036-7406 1395 East Dublin Granville Road, Suite 350
646-366-0860 Columbus, OH 43229
646-366-0864 fax 614-885-0434
614-885-0413 fax
Union Settlement Home Care www.homecareohio.org
219 East 115 Street
New York, NY 10029 Northcoast Health Care Group Co.
212-828-6182 ext 204 Warrensville Center Road, #124
212-828-6190 fax Shaker Heights, OH 44122
216-921-4000
NORTH CAROLINA 216-921-3540 fax
Association for Home Care and Hospice of North
Carolina, Inc. Ohio Hospice & Palliative Care Organization
226 West Millbrook Road 1646 West Lane Avenue, Suite 2
Raleigh, NC 27609 Columbus, OH 43221
919-848-3450 614-485-0021
919-848-2355 fax 614-485-0560 fax
www.homeandhospicecare.org www.ohpco.org
Baptist Hospital Home & Community Health VNA of Cleveland Hospice

Medical Center Boulevard 2500 East 22nd Street
Winston-Salem, NC 27157 Cleveland, OH 44115-3204
828-252-2255 216-931-1450
828-252-9355 fax 216-694-6355 fax
The Carolinas Center for Hospice and OKLAHOMA

End of Life Care Oklahoma Association for Home Care
1011 Dresser Court 8108 NorthWest Tenth, Suite C3
Raleigh, NC 27609-7323 Oklahoma City, OK 73127
919-878-1717 405-495-5995
919-878-0191 fax 405-495-5993 fax
www.carolinasendoflifecare.org www.oahc.com
Johnston Memorial Home Care & Hospice Excell Home Health

P.O. Box 1376 5350 South Western Avenue
Smithfield, NC 27577 Suite 301
919-989-1563 Oklahoma City, OK 73109
919-989-2129 fax 405-631-0521
405-631-2661 fax
NORTH DAKOTA
North Dakota Association for Home Care OREGON
c/o APT, Inc. Oregon Association for Home Care
P.O. Box 2175 1249 Commercial Street SE
Bismarck, ND 58502-2175 Salem, OR 97302
701-224-1815 503-364-2733
701-224-9824 fax 503-399-1029 fax
www.aptnd.com/ndahc www.oahc.org
121
Willamette Valley Hospice Hospice for the Carolinas

2700 Market Street, NE P.O. Box 6009
Salem, OR 97301 West Columbia, SC 29171-6009
503-588-3600 803-791-4220
503-363-3891 fax 803-791-5664 fax
www.hospice-nc-sc.org
PENNSYLVANIA
Pennsylvania Homecare Association Hospice of Charleston
20 Erford Road, Suite 115 3996 Leeds Avenue
Lemoyne, PA 17043 Charleston, SC 29405
717-975-9448 843-529-3100
717-975-9456 fax 843-529-3111 fax
E-mail: vhoak@pahha.org
www.pahha.org
TENNESSEE
Tennessee Association for Home Care, Inc.
Home Nurse, Inc. 131 Donelson Pike
512 West Lancaster Avenue, Suite 2 Nashville, TN 37214-2901
Homestead, PA 19087 615-885-3399
610-975-9600 615-885-4191 fax
610-975-0752 fax www.tahc-net.org
PUERTO RICO UT Medical Center Home Health

2220 Southerland Avenue, Suite 102
Puerto Rico Home Health Agencies and Knoxville, TN 37919
Hospices Association 865-544-6200
P.O. Box 192152
865-544-6240 fax
San Juan, Puerto Rico 00909-2152
787-774-8181 Tennessee Hospital Association Home Care
787-746-1066 fax Alliance
500 Interstate Boulevard South
RHODE ISLAND Nashville, TN 37210-4634
Rhode Island Partnership for Home Care, Inc. 615-256-8240
P.O. Box 603309
615-242-4803 fax
Providence, RI 02906
401-751-2487 Gateway Home Care
401-751-2487 fax Gateway Medical Center
Clarksville, TN 37040
Memorial Hospital of Rhode Island Home Care 931-648-4576
111 Brewster Street
Pawtucket, RI 02860 TEXAS
401-729-3108 Texas Association for Home Care
401-729-2754 fax 3737 Executive Center Drive, Suite 268
Austin, TX 78731
SOUTH CAROLINA 512-338-9293
South Carolina Home Care Association 512-338-9496 fax
P.O. Box 1763
www.tahc.org
Columbia, SC 29202
803-254-7355 Girling Health Care
803-252-0589 fax P.O. Box 4294
Austin, TX 78765
Tuomey Home Health 512-452-5781
31 E. Calhoun Street
512-302-1446 fax
Sumter, SC 29150
kmaxey@girling.com (e-mail)
803-773-4663
803-436-5694 fax
122
UTAH WASHINGTON
Utah Association of Home Health Agencies Home Care Association of Washington
6949 South High Tech Drive, Suite 150 P.O. Box 2016
Midvale, UT 84047 Edmonds, WA 98020
801-255-5888 425-775-8120
801-568-6882 fax 425-771-9588 fax
www.hcaw.org
Health Watch
1750 North 680 West Visiting Nurse Services of the Northwest
Orem, UT 84057 6100 219th Street SW, Suite 400
801-785-8848 Mountlake Terrace, WA 98043
801-785-0821 fax 425-778-2400
425-744-2497 fax
VERMONT
Vermont Assembly of Home Health Agencies WEST VIRGINIA
10 Main Street West Virginia Council of Home Care Agencies,
Montpelier, VT 05602 Inc.
802-229-0579 Route 1, Box 190
802-223-6218 fax Elk Fork Road
www.vnavt.com Middlebourne, WV 26149
304-758-4312
Caledonia Home Health Care and Hospice 304-758-4354 fax
P.O. Box 383
St. Johnsbury, VT 05819 Elite Health Care
802-748-8116 1832 Harper Road
802-748-4628 fax Beckley, WV 25801
304-256-0070
VIRGINIA 304-256-3703 fax
Virginia Association for Home Care
5407 Patterson Avenue, Suite 200B WISCONSIN
Richmond, VA 23226 Wisconsin Homecare Organization
804-285-8636 5610 Medical Circle, Suite 33
800-755-8636 Madison, WI 53719
804-288-3303 fax 608-278-1115
www.vahc.org 608-278-4009 fax
www.wishomecare.org
Circle Home Care
600 Ridge Road Ministry Home Care
Wytheville, VA 24382 303 Upham Street, #208
540-228-0488 Marshfield, WI 54449
540-288-0489 fax 715-387-9685
715-389-3950 fax
Virginia Hospital and Health Care Association
P.O. Box 31394 WYOMING
Richmond, VA 23294 Home Health Care Alliance of Wyoming
804-965-1249 1515 South Spruce Street
804-965-0475 fax Casper, WY 82601
www.vhha.com 307-237-7042 (phone and fax)
Central Wyoming Home Care

401 East Main
Riverton, WY 82501
307-857-0599
307-857-2778 fax
123
APPENDIX
Nursing Assistant/Nurse Aide
Practice Exam
Question Outline
You can use the charts on the next five pages to assess the areas in which you need more study. The column on
the left indicates the topics tested, and the right column indicates the question numbers in that topic.
125
– APPENDIX –
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
126
– APPENDIX –
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
■ Elimination
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
■ Prevention


Communication 16, 34, 47, 48, 49, 58
Client Rights 30, 41, 42, 43, 44, 45, 50, 57, 59
127
– APPENDIX –
TEST 3

Activities of Daily Living: 16, 24, 35, 37, 39, 57, 70
■ Hygiene
■ Elimination
Basic Nursing Skills: 11, 12, 13, 14, 15, 17, 18, 20, 22, 23, 25, 26,
27, 28, 29, 30, 31, 32, 33, 34, 47, 48

■ Prevention

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
128
– APPENDIX –
TEST 4

Activities of Daily Living: 33, 34, 35, 36
■ Hygiene
■ Elimination
Basic Nursing Skills: 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22,
23, 24, 25, 26, 27, 28, 29, 30, 31, 32

■ Prevention

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
129
– APPENDIX –
TEST 5

Activities of Daily Living: 2, 3, 5, 18, 20, 22, 23
■ Hygiene
■ Elimination
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
Restorative Skills: 9, 10, 12, 16, 24

■ Prevention


Communication 14, 53, 54, 55, 56, 57
Client Rights 36, 58, 59, 65, 66, 67, 68, 69, 70
130

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NURSING ASSISTANT/

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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 4: Nursing Assistant/Nurse Aide Practice Exam 2 41

CHAPTER 5: Nursing Assistant/Nurse Aide Practice Exam 3 55

CHAPTER 6: Nursing Assistant/Nurse Aide Practice Exam 4 71

CHAPTER 7: Nursing Assistant/Nurse Aide Practice Exam 5 85

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

Education and Training The nursing assistant profession, on the whole, is

simply go in to demonstrate your competence by tak- ■ Client’s Rights—such as privacy, grievances,

and textbooks to prepare for certification. ARKANSAS

DISTRICT OF COLUMBIA KANSAS

MINNESOTA NEW HAMPSHIRE

RHODE ISLAND VIRGINIA

SOUTH CAROLINA WASHINGTON

■ Being unfamiliar with the format of the exam

What’s the common denominator in all these Step 1: Get Information

Part B: What’s on the Test Stress Management

Your Test Anxiety Score

Use the process of elimination to answer the following questions.

Your Guessing Ability

4. American author Gertrude Stein was born in

Are you a risk-taker? Diet

Step 8: Get Your Act Together Don’t Skip Breakfast

Find Out Where the Test Is and

Getting to the Exam Site

Location of exam site:

Time it will take to get to exam site:

Things to Lay Out the Night Before

Clothes I will wear

Other Things to Bring/Remember

Schedule A: The 30-Day Plan

Time Preparation Time Preparation

Schedule B: The 10-Day Plan

Time Preparation Time Preparation

6. The proper medical abbreviation for before

Exam 1 5. When assisting a client in and out of bed, the

50. Before bathing a client, the nursing assistant 55. A prosthesis is

Answers and Explanations

Pretest Practice 5. a. You should always use good body mechanics

6. The purpose of correctly positioning the client

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

58. Which statement about mouth care for uncon-

Answers and Explanations

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

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

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

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

43. Nonverbal communication includes

Answers and Explanations

Exam 3 14. c. Any fluid taken in or released from the body is

58. b. Consideration of cultural or religious beliefs is

6. The nurse aide, a member of the healthcare

Answers and Explanations

Exam 4 14. c. A clean dressing is nonsterile but promotes