Intro to Healthcare & Resident Rights
17%of exam
Resident RightsHIPAAMandated ReportingCommunication
Basic Nursing Skills
17%of exam
Vital SignsPositioningNutritionEnd of Life Care
Personal Care
17%of exam
HygieneGroomingADLsResident Environment
Infection Prevention & Control
11%of exam
Hand HygienePPEPrecautionsChain of Infection
Safety
11%of exam
Fire SafetyFallsBody MechanicsRestraints
Mental Health/Illness & Cognitive Impairment
12%of exam
DementiaDeliriumSundowningValidation Therapy
Body Systems
9%of exam
IntegumentaryCardiovascularRespiratoryNeurological
Rehabilitation & Restorative Care
5%of exam
ROMContracturesRestorative GoalsAssistive Devices
Quick Facts
- Exam
- UT CNA Competency
- Written Qs
- 75 questions
- Written Time
- 2 hours
- Pass Score
- 75% (57/75)
- Skills Tested
- 5 of 20
- Skills Time
- 45 minutes
- Training
- 100 hrs (24 clinical)
- Blueprint
- 3rd Ed. Nov 2024
Renewal vs Recertification
Renewal
- 200 hrs worked
- No retest needed
Recertification
- 6-24 months expired
- Must retest fully
Worked hours vs retest
OBRA Resident Rights
- Privacy
- Personal care and records
- Dignity
- Respectful, person-directed treatment
- Right to refuse
- Can decline any care
- Freedom from restraints
- No unnecessary physical restraint
- Freedom from abuse
- No harm or neglect
- Confidentiality
- Private health information protected
- Grievances
- Complain without retaliation
Mandated Reporting & Legal
- Mandated reporter
- Must report suspected abuse
- APS
- Adult Protective Services agency
- Abuse
- Intentional harm to resident
- Neglect
- Failure to provide care
- Exploitation
- Misuse of resident funds
- HIPAA
- Protects health information privacy
- Scope of practice
- What a CNA may do
Systolic vs Diastolic Pressure
Systolic
- Top number
- Heart contracts
- Pressure peak
Diastolic
- Bottom number
- Heart rests
- Pressure lowest
Top vs bottom number
Abnormal Vital Sign Picker
- Pulse under 60 or 100+→Report to nurse
- Respirations under 12 or 20+→Report to nurse
- BP at or above 140/90→Report, possible hypertension
- BP below 90/60→Report, possible hypotension
- Temp above 100.4°F→Report, possible fever
- SpO2 below 95%→Report, possible hypoxia
Normal Adult Vital Signs
- Temperature (oral)
- 97.6-99.6°F
- Pulse
- 60-100 beats per minute
- Respirations
- 12-20 breaths per minute
- Blood pressure
- Below 120/80 mmHg
- Pulse oximetry
- 95-100% oxygen saturation
- Radial pulse site
- Thumb side of wrist
- Apical pulse site
- Left side of chest
ADLs & Body Positions
- ADLs
- Bathing, dressing, eating, toileting
- Fowler's
- Head raised 45-60 degrees
- Semi-Fowler's
- Head raised 30-45 degrees
- Supine
- Lying flat on back
- Prone
- Lying flat on stomach
- Lateral
- Lying on one side
- Dangle
- Sit, legs over bedside
ADL Assistance Level Picker
- Resident does task alone→Independent, no help needed
- Needs cueing or standby→Supervision only
- Needs some physical help→Limited assistance
- Needs help both sides→Extensive assistance
- Cannot participate at all→Total dependence care
Personal Care & Hygiene Order
- Unaffected side first
- Undress weak side last
- Affected side first
- Dress weak side first
- Perineal care direction
- Front to back always
- Clean to dirty
- Wash cleanest areas first
- Denture storage
- Labeled cup with water
- Call light placement
- Always within resident's reach
Resident Environment & Comfort
- Bed height
- Working height, then lower
- Side rails
- Per care plan only
- Clothing choice
- Resident chooses own clothes
- Room temperature
- Comfortable, resident preference
- Cultural competence
- Respect beliefs and customs
Droplet vs Airborne Precautions
Droplet
- Large particles
- Mask, 3-6 feet
- Flu, pertussis
Airborne
- Tiny particles
- N95 required
- TB, measles
Distance vs airflow spread
Precaution Type Picker
- Any resident contact→Standard precautions(Baseline always)
- C. diff, MRSA, wound→Contact precautions(Gown and gloves)
- Flu, pertussis, mumps→Droplet precautions(Mask within 6 feet)
- TB, measles, chickenpox→Airborne precautions(N95, negative pressure)
- High-contact daily tasks→Enhanced barrier precautions(No active infection)
Infection Control Basics
- Chain of infection
- Pathogen, reservoir, portal, host
- Hand hygiene
- Most important infection control step
- Handwashing time
- At least 20 seconds
- PPE order (don)
- Gown, mask, goggles, gloves
- PPE order (doff)
- Gloves, goggles, gown, mask
- Standard precautions
- Used with every resident
Transmission-Based Precaution Types
- Contact precautions
- Gown and gloves, e.g. MRSA
- Droplet precautions
- Mask within 3-6 feet
- Airborne precautions
- N95 mask, negative pressure room
- Enhanced barrier precautions
- High-contact care, no infection
- Reverse isolation
- Protects immunocompromised resident
Fire Safety (RACE)
RACE: Rescue, Alarm, Confine, Extinguish
Rescue: remove residentsAlarm: pull stationConfine: close doorsExtinguish: use PASS
FWB vs NWB Mobility
FWB
- Full weight allowed
- Normal gait aid
NWB
- No weight allowed
- Wheelchair or crutches
Can bear vs cannot
Emergency Response Picker
- Resident falling→Ease to floor(Never catch full weight)
- Fire discovered→RACE protocol(Rescue first)
- Stroke symptoms seen→F.A.S.T. check(Then call 911)
- Conscious resident choking→Abdominal thrusts(Heimlich maneuver)
- Suspected abuse or neglect→Report to APS(Mandatory, immediate)
Safety & Emergency Response
- RACE
- Rescue, Alarm, Confine, Extinguish
- PASS
- Pull, Aim, Squeeze, Sweep
- F.A.S.T.
- Face, Arm, Speech, Time
- Gait belt
- Snug, no twists, fingers fit
- Body mechanics
- Bend knees, keep back straight
- Fall response
- Ease resident down, don't catch
Extinguisher Use (PASS)
PASS: Pull, Aim, Squeeze, Sweep
Pull: safety pinAim: at baseSqueeze: the handleSweep: side to side
Restraints & Mobility Aids
- Restraint alternatives
- Try before using restraints
- FWB
- Full weight bearing allowed
- NWB
- No weight bearing allowed
- PWB
- Partial weight bearing allowed
- Gait belt use
- Required for unsteady transfers
Stroke Recognition (F.A.S.T.)
F.A.S.T.: Face, Arm, Speech, Time
Face: drooping checkArm: weakness checkSpeech: slurred wordsTime: call 911
Maslow's Priority Order
Physiological, Safety, Love, Esteem, Self-actualization
Physiological: food and airSafety: security needs firstLove: belonging needs nextEsteem: respect and dignity
Delirium vs Dementia
Delirium
- Sudden onset
- Often reversible
- Medical cause
Dementia
- Gradual onset
- Progressive
- Irreversible decline
Sudden vs gradual onset
Mental Health & Dementia Care
- Dementia
- Gradual, progressive cognitive decline
- Delirium
- Sudden, often reversible confusion
- Sundowning
- Worse confusion in evening
- Validation therapy
- Agree with resident's reality
- Redirection
- Shift focus, reduce agitation
- Maslow's hierarchy
- Physiological needs come first
Body Systems Key Terms
- Integumentary
- Skin, hair, nails
- Musculoskeletal
- Bones, muscles, joints
- Cardiovascular
- Heart and blood vessels
- Respiratory
- Lungs and airways
- Gastrointestinal
- Digestion, stomach, intestines
- Urinary
- Kidneys, bladder, elimination
- Neurological
- Brain, spinal cord, nerves
Active ROM vs Passive ROM
AROM
- Resident moves self
- Builds strength
PROM
- CNA moves limb
- Prevents contractures
Self-move vs assisted-move
Restorative & Rehabilitative Care
- AROM
- Active range of motion
- PROM
- Passive range of motion
- Contracture
- Permanent muscle/joint shortening
- Restorative care goal
- Maintain current function level
- Rehabilitative care goal
- Restore lost function
Common Traps
Droplet vs Contact Precautions
Droplet needs a mask ≠ Contact needs gown, gloves
Reporting vs Recording
Reporting is verbal ≠ Recording is written
Independence vs Safety
Promote independence first ≠ Never skip safety
Restorative vs Rehabilitative Care
Restorative maintains function ≠ Rehab restores lost function
No-Show vs Failed Attempt
No-show forfeits fee only ≠ Failed attempt still counts
Abuse vs Neglect
Abuse is intentional harm ≠ Neglect is failure to act
Last Minute
- 1.75 questions, 75% passing score
- 2.57 correct answers minimum needed
- 3.Two hours for written exam
- 4.Five skills, one per category
- 5.80% per skill, 100% key steps
- 6.45 minutes for skills exam
- 7.Three attempts within one year
- 8.200 hours worked for renewal
- 9.Report abuse to APS immediately
- 10.RACE for fire, PASS for extinguisher
- 11.F.A.S.T. for stroke recognition
- 12.Greet, introduce, identify as CNA
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