Basic Nursing Skills
20%of exam
Vital SignsI&OPositioningNutritionSkin Safety
Safety + Emergency
11%of exam
FallsBody MechanicsFire SafetyChokingEquipment
Resident Rights
11%of exam
DignityPrivacyRefusalPOLSTOmbudsman
Role + Responsibility
8%of exam
ScopeDelegationChain of CommandMandated Reporting
Infection Control
8%of exam
Hand HygienePPEStandard PrecautionsIsolationCleaning
Mental Health
8%of exam
Cognitive Care
7%of exam
DementiaSundowningRedirectionWanderingRoutine
Communication
7%of exam
Personal Care
5%of exam
BathingOral CarePerineal CareDressingToileting
Data + Reporting
5%of exam
Objective DataSubjective DataI&OIncidentsCharting
Disease Process
5%of exam
CHFCOPDDiabetesStrokeDVT
Aging + Restorative
5%of exam
ROMAmbulationIndependenceContracturesWeak Side
Quick Facts
- Exam
- California CNA
- Vendor
- D&S Headmaster
- Knowledge
- 75 questions
- Written time
- 60 min
- Pass
- 75%
- Skills time
- 30 min
- Training
- 160 hours
- Renewal
- 2 years
Skills Flow
Knock, wash, explain, privacy, safety
IdentifyGatherPerformDocument
Skills Picker
- Before any skill→Wash hands
- Transfer resident→Gait belt
- Weak side dressing→Dress first
- Catheter care→Clean away
- Measure output→Eye level
- Finish care→Call light
Basic Skills
- Oral temp
- 98.6 F typical
- Pulse
- Count beats
- Respirations
- Count quietly
- BP cuff
- Bare upper arm
- I&O
- Measure intake/output
- Edema
- Report swelling
- Skin check
- Observe redness
- Positioning
- Prevent pressure
Skills Test
- Handwashing
- Mandatory skill
- Indirect care
- Every skill
- Privacy
- Curtain/cover
- Safety
- Lock/check
- Measurement
- Exact reading
- Supplies
- Gather first
- Closing
- Comfort/call light
Fire Response
RACE first, PASS only if safe
RescueAlarmContainExtinguishPullAim
Safety + Emergency
- Fall risk
- Call light near
- Gait belt
- Transfer support
- Bed wheels
- Locked before care
- Low bed
- Fall prevention
- RACE
- Fire response
- PASS
- Extinguisher use
- Choking
- Call for help
- Oxygen
- No flames
Abuse vs Neglect
Abuse
- Harmful act
- Intent possible
- Report immediately
Neglect
- Needed care missing
- Unmet needs
- Also report
Harm vs omission
Rights + Ethics
- Dignity
- Respect choices
- Privacy
- Cover body
- Confidentiality
- Protect information
- Refusal
- Report refusal
- Visitors
- Respect access
- Unopened privacy
- Ombudsman
- Rights advocate
- POLST
- Medical order
POLST vs Directive
POLST
- Medical order
- Current treatment
- Honor directions
Directive
- Future wishes
- Planning document
- Not same
Order vs wishes
Scope vs Delegation
Scope
- Allowed tasks
- CNA role
- No diagnosis
Delegation
- Assigned by nurse
- Clear directions
- Report back
Can do vs assigned
Escalation Picker
- Abuse suspected→Report now
- Chest pain→Notify nurse
- New confusion→Notify nurse
- Resident refuses→Report refusal
- Fall occurs→Stay/report
- Care not assigned→Ask nurse
Exam Format
- Knowledge
- 75 items60 min
- Passing
- 57 correct
- Skills
- Timed demo30 min
- Standard fee
- $140 total
- Audio exam
- $45 option
- TMU
- Scheduling portal
- CDPH
- State registry
California Rules
- Training
- 160 hours
- Theory
- 60 hours
- Clinical
- 100 hours
- Live Scan
- Before residents
- Renewal
- Every 2 years
- CE
- 48 hours
- Paid work
- 8 hours
Infection Chain
Break any link; hand hygiene wins
AgentReservoirExitEntryHost
Standard vs Transmission
Standard
- Every resident
- Body fluids
- Hand hygiene
Transmission
- Added precautions
- Known risk
- Special PPE
Always vs added
Precaution Picker
- All resident care→Standard
- Body fluids likely→Gloves
- Splash risk→Mask/eye
- Contact isolation→Gown/gloves
- Droplet illness→Mask
- Airborne illness→Special room
Infection Control
- Hand hygiene
- Best prevention
- Standard
- All residents
- Contact
- Gown/gloves
- Droplet
- Mask needed
- Airborne
- Special room
- Clean
- Least dirty first
- Sharps
- Never recap
- Biohazard
- Red bag
Mental + Cognitive
- Dementia
- Memory decline
- Sundowning
- Evening confusion
- Validation
- Acknowledge feelings
- Redirection
- Shift attention
- Wandering
- Maintain safety
- Depression
- Report withdrawal
- Delusion
- False belief
SBAR
Situation, Background, Assessment, Recommendation
What nowHistoryWhat observedWhat needed
Communication
- Call light
- Within reach
- Aphasia
- Language difficulty
- Hearing loss
- Face resident
- Vision loss
- Identify yourself
- Interpreter
- Language support
- Open question
- More detail
- Closed question
- Short answer
Personal Care
- Bathing
- Promote privacy
- Perineal
- Front to back
- Catheter
- Clean away
- Oral care
- Aspiration watch
- Dentures
- Line basin
- Dressing
- Weak side first
- Nail care
- No diabetic trim
Objective vs Subjective
Objective
- Measured
- Observed
- Chart facts
Subjective
- Resident states
- Symptoms
- Quote if needed
Seen vs said
Reporting
- Objective
- Seen/measured
- Subjective
- Resident says
- Charting
- Timely facts
- Incident
- Report promptly
- Abuse
- Report immediately
- Neglect
- Unmet needs
- SBAR
- Structured report
Disease Process
- CHF
- Fluid overload
- COPD
- Breathing difficulty
- Diabetes
- Glucose problem
- Stroke
- FAST signs
- DVT
- Leg clot
- Pressure injury
- Skin breakdown
- Dehydration
- Low fluids
ADL vs Restorative
ADL
- Daily care
- Assist safely
- Maintain hygiene
Restorative
- Promote function
- Practice ability
- Prevent decline
Assist vs improve
Restorative Care
- ROM
- Joint movement
- Contracture
- Shortened muscle
- Ambulation
- Walking assist
- Independence
- Do self
- Weak side
- Dress first
- Cane
- Strong side
- Prosthesis
- Device replacement
Common Traps
Training hours
California requires 160 ≠ Not 150 hours
Scope drift
CNA reports data ≠ Nurse assesses
Privacy vs confidentiality
Privacy covers body ≠ Confidentiality covers information
Refusal of care
Resident may refuse ≠ CNA must report
Diabetic nail care
Clean and observe ≠ Do not trim
Skill timing
Safety throughout ≠ Not only ending
Last Minute
- 1.Knowledge: 75 questions, 60 min
- 2.Passing: 57 correct
- 3.Skills: 30 min
- 4.Training: 60 theory, 100 clinical
- 5.Renewal: 48 CE hours
- 6.Wash hands before care
- 7.Call light within reach
- 8.Privacy before exposure
- 9.Report abuse immediately
- 10.CNA reports; nurse assesses
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