Physical Care Skills
57%of exam
Infection + Safety
12%of exam
Role + Communication
26%of exam
ScopeReportingCommunicationDocumentation
Psychosocial Care
10%of exam
DementiaBehaviorCultureGrief
Maryland + GNA Scope
11%of exam
MBON RulesGNA RuleRegistryCMA PathMD Picker
Quick Facts
- Credential
- Maryland CNA/GNA
- Regulator
- Maryland MBON
- Vendor
- Credentia (NNAAP)
- Training
- 100 MBON hours
- Written
- 70 questions
- Pass
- 70% (49/70)
- Skills
- 5 in 30 min
- Renewal
- 2 years, $40
Care Order
Clean before dirty, weak before strong
Face firstPeri lastDress weak sideUndress strong side
Active vs Passive ROM
Active ROM
- Resident moves
- Aide encourages
- Promotes independence
Passive ROM
- Aide moves joint
- Resident cannot
- Prevents contracture
Resident vs aide
Skills Picker
- Before resident contact→Hand hygiene
- Starting any skill→Provide privacy
- Before transfer→Lock brakes
- Resident stands→Use gait belt
- Feeding resident→Sit upright
- Pulse assigned→Count full minute
- Measurement assigned→Record result
- Skill complete→Call light reach
Vital Signs
- Temperature
- Body heat
- Pulse
- Rate and rhythm
- Respirations
- Count quietly unnoticed
- BP
- Systolic over diastolic
- Apical pulse
- Fifth intercostal, midclavicular
- Radial pulse
- Wrist artery
- Tympanic adult
- Pinna up back
- Abnormal value
- Report to nurse
Personal Care
- Privacy
- Close curtains door
- Drape
- Expose only area
- Bath order
- Clean to dirty
- Eyes
- Inner to outer
- Face
- Plain water only
- Perineal care
- Front to back
- Unconscious oral
- Lateral, head turned
- Denture
- Line basin towel
Positioning + Mobility
- Supine
- On back
- Lateral
- On side
- Fowler
- Head elevated
- Dangling
- Sit before standing
- Transfer
- Lock brakes first
- Gait belt
- Transfer support
- Cane
- Strong side holds
- Walker
- Move walker first
Nutrition + Elimination
- Aspiration
- Food enters airway
- Dysphagia
- Swallowing difficulty
- Feeding
- Upright, small bites
- Thickened liquids
- Swallow protection
- I&O
- Intake and output
- NPO
- Nothing by mouth
- Bedpan
- Fowler if able
- Refusal
- Report, do not force
Fire RACE
Rescue, alarm, contain, extinguish
Rescue residentsActivate alarmContain fireExtinguish/evacuate
Sterile vs Clean
Sterile
- No microbes
- Nurse procedures
- Not CNA scope
Clean
- Reduced microbes
- CNA daily care
- Clean before dirty
Free vs reduced
Emergency Picker
- Resident falls→Help, do not move
- Choking occurs→Call for help
- Fire seen→RACE
- Unresponsive resident→Activate emergency
- New chest pain→Report immediately
- C. diff care→Soap and water
- Abuse suspected→Report immediately
- Spill occurs→Follow facility policy
Hand Hygiene + PPE
- Soap friction
- At least 20 seconds
- Visible soil
- Use soap water
- C. diff
- Soap water only
- ABHR
- No visible soil
- Don order
- Gown, mask, gloves
- Doff order
- Gloves, gown, mask
- Faucet
- Paper towel barrier
- After gloves
- Wash hands again
PASS
Pull, aim, squeeze, sweep
Pull pinAim baseSqueeze handleSweep side-to-side
Precautions + Safety
- Standard
- Every resident always
- Contact
- Gloves and gown
- Droplet
- Mask close care
- Airborne
- Special room mask
- Call light
- Within reach
- Bed
- Low and locked
- Fall found
- Help, do not move
- Restraint
- Only nurse order
Objective vs Subjective
Objective
- Observed data
- Measured vital
- Factual charting
Subjective
- Resident says
- Pain report
- Quoted complaint
Seen vs said
Role + Scope
- CNA role
- Direct resident care
- Nurse
- Assesses and plans
- Delegation
- Nurse assigns tasks
- Care plan
- Follow exactly
- Diagnosis
- Never CNA duty
- Medication
- Not CNA scope
- Outside scope
- Decline, tell nurse
- Documentation
- Facts only
Abuse vs Neglect
Abuse
- Intentional harm
- Physical verbal sexual
- Report immediately
Neglect
- Care omitted
- Needs unmet
- Report immediately
Harm vs omission
Communication + Reporting
- Active listening
- Attend and reflect
- Open question
- Encourages detail
- SBAR
- Structured report
- Objective
- Observed or measured
- Subjective
- Resident states
- Aphasia
- Simple sentences, time
- Limited English
- Use interpreter
- Chest pain
- Report nurse immediately
Report vs Record
Report
- Tell nurse
- Condition change
- Verbal SBAR
Record
- Chart facts
- Care performed
- Written documentation
Tell vs chart
Rights + Legal
- Privacy
- Information and body
- Dignity
- Respectful care
- Refuse treatment
- Resident right
- Confidentiality
- Need-to-know only
- Abuse
- Report immediately
- Neglect
- Care omitted
- Mandated reporter
- CNA must report
- Advance directive
- Care wishes document
Maryland Numbers
100 train, 120 register, 2-year renew
100 training hours120-day rule70% pass$40 renewal
CNA vs GNA
CNA
- Basic Maryland level
- All settings
- Foundation cert
GNA
- Added cert
- Nursing homes required
- Same NNAAP exam
Basic vs nursing-home
Maryland Picker
- Want certification→100 MBON hours
- Work nursing home→Need GNA
- Hired at home→Register 120 days
- Failed first try→Retrain then retest
- Want CMA→GNA plus year
- Certification expiring→Renew $40
- Check status→MBON verification
- Suspected abuse→Report, document
Exam Facts
- Format
- Credentia NNAAP
- Written
- 70 questions
- Written time
- Two hours
- Pass mark
- 70 percent
- Skills test
- Five skills
- Skills time
- About 30 minutes
- Oral option
- English or Spanish
- Two parts
- Pass both required
Maryland Rules
- MBON
- Maryland Board Nursing
- Training
- 100 approved hours
- Clinical hours
- MD licensed home
- COMAR 10.39
- CNA regulations
- 120-day rule
- Register after hire
- First fail
- Retrain before retake
- Background check
- Required statewide
- Skills list
- Maryland skill listing
Registry + Renewal
- Registry
- CNA database + GNA
- Verify free
- MBON license lookup
- Term
- Two years
- Renewal fee
- Forty dollars
- GNA renewal
- No added cost
- Expires
- 28th of birth month
- Year parity
- Matches birth year
- Work proof
- Paid nurse-aide work
GNA + CMA Path
- CNA
- Basic Maryland certification
- GNA
- Required nursing homes
- Comprehensive care
- Needs GNA
- Same exam
- GNA NNAAP test
- CMA
- Certified Medicine Aide
- CMA needs GNA
- Plus one year
- CMA course
- 60-hour community college
- Dialysis tech
- Separate certification
Common Traps
Maryland retake
First fail = retrain ≠ Not just reschedule
CNA vs GNA
GNA for nursing homes ≠ Same NNAAP exam
120-day rule
Register within 120 days ≠ Not training deadline
C. diff hygiene
Soap and water ≠ Sanitizer fails spores
PPE removal
Gloves first ≠ Mask last
Perineal direction
Front to back ≠ Never back to front
Resident falls
Do not move ≠ Call nurse first
Scope boundary
Report changes ≠ Never diagnose
Last Minute
- 1.Maryland needs 100 MBON training hours
- 2.Written: 70 questions, 2 hours
- 3.Pass written at 70 percent
- 4.Skills: 5 tasks, 30 minutes
- 5.GNA required for nursing homes
- 6.Register within 120 days of hire
- 7.First fail means retrain then retest
- 8.Renewal: 2 years, $40 fee
- 9.Hand hygiene is always scored
- 10.C. diff: soap and water only
- 11.Perineal care front to back
- 12.Abuse suspicion: report now
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