Basic Nursing Skills
13%of exam
VitalsADLsComfortPositioningEnd of Life
Personal Care
13%of exam
BathingOral CareDressingToiletingFeeding
Infection Control
13%of exam
Hand HygienePPEPrecautionsSharpsCleaning
Data Collection
11%of exam
Vital SignsI&ODocumentationObservationReporting
Client Rights
10%of exam
DignityPrivacyRefusalPOLSTOBRA
Communication
10%of exam
Mental Health
8%of exam
DementiaDepressionAnxietyValidationGrief
Role and Responsibility
8%of exam
ScopeDelegationOSBN RulesEthicsCMA
Disease Process
6%of exam
CHFCOPDDiabetesStrokeAging Changes
Care of Impaired
5%of exam
Alzheimer'sSensory LossRestorativeROMFunction
Safety
5%of exam
FallsBody MechanicsFireEmergencyEquipment
Quick Facts
- Knowledge exam
- 80 questions
- Knowledge time
- 90 minutes
- Knowledge pass
- 73%
- Skills tasks
- 3 or 4
- Skills time
- 35 minutes
- Skills pass
- All key steps + 80%
- Vendor
- D&S Headmaster (TMU)
- Fee
- $106 total
- Training
- 105 hours
Every Skill Task Bookend
Knock, explain, privacy, care, call light, wash hands
Knock/hygiene startExplain procedurePrivacy/safetyCall light/hygiene end
Key Step vs Non-Key Step
Key step
- Bolded in handbook
- 100% required
- Any miss fails task
Non-key step
- Not bolded
- 80% required
- Some misses allowed
Zero-miss vs 80% floor
Skill Task Picker
- Start any skill task→Knock, hand hygiene
- Before exposing resident→Pull curtain first
- Any transfer task→Lock brakes first
- Recording a measurement→Match RN tolerance
- Finish a task→Call light in reach
- Believe a step missed→Tell RN, redo step
Skills Test Format
- Task count
- 1 mandatory + 2-3 random
- Mandatory task
- Embeds full handwashing
- Key steps
- 100% required, no misses
- Non-key steps
- 80% required to pass
- Manikin tasks
- Catheter, perineal care x2
- Other tasks
- Live resident actor
- Corrections
- Redo step, must demonstrate
- Order
- Free unless before/after used
Mandatory vs Random Task
Mandatory task
- 1 of 5 options
- Embeds full handwashing
- Always task one
Random tasks
- 2 or 3 assigned
- From 15-task list
- Comparable difficulty
Fixed first vs drawn rest
15 Skill Tasks
- Ambulate
- Walker + gait belt, 10 steps
- Bedpan
- Measure outputMandatory
- Feed client
- Meal in bed, upright 45°
- Partial bath
- Face, arm, hand, armpit
- Catheter care
- Male, manikinMandatory
- Dress client
- Bedridden, weak side first
- Mouth care
- Brush all tooth surfaces
- Perineal care F
- ManikinMandatory
- Perineal care M
- Manikin, soiled briefMandatory
- Gown/gloves
- Drainage bag outputMandatory
- ROM
- Shoulder, hip, knee x3
- Reposition
- Side-lying, correct side
- BP + pulse ox
- Brachial cuff, finger sensor
- Temp/pulse/resp
- Infrared, radial, 60 sec
- Transfer
- Wheelchair to bed, gait belt
Personal Care
- Bathing order
- Face first, perineal last
- Perineal care
- Front to back, clean stroke
- Catheter care
- Strokes away from urethra
- Dressing
- Weak side first on
- Undressing
- Strong side first off
- Oral care
- Watch for aspiration risk
- Denture care
- Line basin, avoid drop
- Fluids at meals
- Offer frequently
Handwashing Sequence
Wet, soap, scrub 20 sec, rinse down, dry, towel-off
Wet handsSoap all surfaces20 sec frictionFingers point down
Precaution Picker
- Any resident contact→Standard precautions
- Contact with body fluids→Gloves, gown
- Droplet illness→Mask within 6 ft
- Airborne illness→Special negative-pressure room
- Multi-drug resistant organism→Contact isolation
- Splash risk→Mask and eye shield
Infection Control
- Hand hygiene
- 20 sec with soap
- Sanitizer
- Cover, rub until dry
- Standard precautions
- Every resident, every time
- Contact
- Gown and gloves
- Droplet
- Mask within 3-6 ft
- Airborne
- Special ventilation room
- Sharps
- Never recap needles
- Biohazard
- Red bag disposal
Objective vs Subjective
Objective
- Measured
- Observed
- Chart the fact
Subjective
- Resident states
- Symptom report
- Quote if needed
Seen vs said
Measurement Tolerance
- Temperature
- Within 0.1 degree
- Pulse
- Within 4 beats
- Respirations
- Within 2 breaths
- Blood pressure
- Within 6 mmHg
- Pulse oximetry
- Within 1 point
- Urinary output
- Within 25 mL
- Fluid intake
- Within 40 mL
- Solid intake %
- Within 25 points
Vital Sign Ranges
- Oral temp
- 97.6-99.6 F
- Pulse
- 60-100 bpm
- Respirations
- 12-20 per minute
- Normal BP
- Below 120/80
- Elevated BP
- 120-129 over under 80
- O2 saturation
- 95-100%
- BP cuff inflate
- 160-180 mmHg
- Irregular breathing
- Count full 60 sec
Abuse vs Neglect
Abuse
- Harmful act
- Physical or verbal
- Report immediately
Neglect
- Needed care missing
- Unmet basic needs
- Also mandatory report
Harm vs omission
Resident Rights
- OBRA rights
- 1987 federal nursing-home law
- Dignity
- Respect resident choices
- Privacy
- Curtain before exposure
- Confidentiality
- Protect health information
- Refusal
- Resident may refuse, report
- POLST
- Active medical order
- Advance directive
- Future care wishes
- Restraints
- Last resort, must report
POLST vs Directive
POLST
- Signed medical order
- Current treatment
- Follow now
Advance directive
- Future wishes
- Planning document
- Guides decisions later
Order vs wishes
SBAR
Situation, Background, Assessment, Recommendation to nurse
What nowHistoryWhat observedWhat needed
Communication
- SBAR
- Structured nurse report
- Objective data
- Seen or measured facts
- Subjective data
- What resident states
- Active listening
- Face resident, eye contact
- Aphasia
- Allow extra response time
- Hearing loss
- Face client, speak clearly
- Interpreter
- Use for language barrier
- Charting
- Timely, factual, objective
Mental + Cognitive
- Dementia
- Progressive memory decline
- Alzheimer's
- Common dementia cause
- Sundowning
- Evening confusion increase
- Redirection
- Shift attention gently
- Validation
- Acknowledge feelings, not correct
- Depression signs
- Withdrawal, appetite change
- Anxiety
- Report new agitation
- Grief
- Support without minimizing
CNA vs CMA
CNA
- Core certification
- No medications
- Reports data to nurse
CMA
- Extra OSBN training
- Certain meds only
- Delegated by nurse
Base role vs added scope
Escalation Picker
- Abuse or neglect suspected→Report immediately
- BP over 160/90→Notify nurse now
- New confusion or pain→Notify nurse
- Resident refuses care→Report the refusal
- Task outside CNA scope→Decline and report
- Fall occurs→Stay, call for help
Exam Format
- Knowledge
- 80 questions90 min
- Passing
- 73% or better
- Skills
- 3-4 tasks35 min
- Vendor
- D&S Headmaster
- Scheduling
- Oregon TMU portal
- Same day
- Knowledge + skills
- Audio exam
- Request at OSBN application
- Remote option
- Proctored knowledge only
Old vs Current Training Hours
Pre-2025 rule
- 155 total hours
- 80 classroom/lab
- 75 clinical
Since July 2025
- 105 total hours
- 37 class, 28 lab
- 40 clinical
Obsolete vs current
Renewal + Reactivation Picker
- On-time renewal→2 hrs cultural CE
- Lapsed under 2 years→Standard reinstatement steps
- Lapsed over 2 years→One test attempt allowed
- Fail after lapse retest→Retrain, then unlimited
- Fail knowledge or skills→Pay retest, reschedule
- Dispute a score→File review in 3 days
Oregon Rules
- Training
- 105 hours minimum
- Classroom
- 37 hours
- Lab
- 28 hours
- Clinical
- 40 hours
- CNA levels
- One level since 2025
- Renewal
- 48-month cycle
- Renewal CE
- 2 cultural-competency hours
- Application
- Expires after 1 year
- Test attempts
- Unlimited after training
Fees + Retakes
- Certification fee
- $106 total
- Skills retest
- $45
- Knowledge retest
- $25
- Test review deposit
- $25, 3 days
- Lapse over 2 yrs
- 1 attempt, then retrain
- Results
- Available next business day
Reporting + Legal
- Mandatory reporter
- All CNAs, by ORS 124
- Report to
- Supervisor and APS
- Timing
- Immediately, not end of shift
- Physical abuse
- Harmful contact, intent
- Verbal abuse
- Threats or humiliation
- Neglect
- Needed care withheld
- Registry finding
- Blocks Medicare/Medicaid work
- CMA duties
- Extra training, meds only
Disease + Restorative
- CHF
- Fluid overload, edema
- COPD
- Breathing difficulty
- Diabetes
- Watch blood sugar signs
- Stroke
- FAST warning signs
- Flexion
- Bends the joint
- Extension
- Straightens the joint
- Abduction
- Moves limb away
- Adduction
- Moves limb toward
ROM Direction Pairs
Flex bends, extend straightens, abduct away, adduct toward
Flexion bendExtension straightenAbduction awayAdduction toward
Fire Response
RACE first: rescue, alarm, contain, extinguish or evacuate
Rescue residentAlarm soundsContain doorsExtinguish/evacuate
Safety Rules
- Bed brakes
- Lock before any transfer
- Wheelchair brakes
- Lock before standing
- Gait belt
- Snug, underhand grip
- Call light
- Always within reach
- Body mechanics
- Bend knees, straight back
- Fall risk
- Low bed, clear path
- Face obstruction
- Counts double if missed
- Fire response
- Rescue, alarm, contain, extinguish
Common Traps
Key steps vs non-key steps
Key steps need 100% ≠ Non-key allow 20% miss
Training hours changed
Current rule is 105 ≠ 155 hours is obsolete
CNA1/CNA2 no longer split
One CNA level now ≠ Merged July 1 2025
Reactivation is not retest
Lapse over 2 years differs ≠ Only one attempt allowed
Manikin vs live actor
Catheter, perineal on manikin ≠ Other tasks use actor
Audio exam timing
Request at OSBN application ≠ Not available on test day
Renewal has no work hours
2026 drops 400-hour rule ≠ Only 2 CE hours required
Last Minute
- 1.Knowledge: 80 questions, 73% pass
- 2.Knowledge time: 90 minutes total
- 3.Skills: 35 minutes, 3-4 tasks
- 4.All key steps: zero misses
- 5.Non-key steps: 80% overall
- 6.Training minimum: 105 total hours
- 7.Exam fee: $106 total
- 8.Retest fees: $45 skills, $25 knowledge
- 9.Renewal: 2 CE hours, 48 months
- 10.Lock brakes before every transfer
- 11.Wash hands before and after skills
- 12.Report abuse or neglect immediately
- 13.CNA never gives medications
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