Activities of Daily Living
22%of exam
Basic Nursing Skills
35%of exam
Self-care + Independence
7%of exam
Psychosocial Care
10%of exam
Emotional NeedsDementiaCultureCommunicationBehavior Support
Nurse Aide Role
25%of exam
Quick Facts
- Credential
- NAC
- Common name
- Washington CNA
- Written
- 70 MCQ
- Pretest
- 10 unscored
- Time
- 2 hours
- Knowledge fee
- $55
- Skills fee
- $100
- Sequence
- Skills first
- Training
- 108 hours
Bathing Order
Clean areas first, perineal care last.
Face firstDirty lastGlovesPrivacy
ADL Action Picker
- Resident can assist→Encourage independence
- Bathing resident→Protect privacy
- Unconscious oral care→Side position
- Weak arm dressing→Dress weak first
- Meal assistance→Sit upright
- Swallowing trouble→Stop and report
- Soiled brief→Change promptly
- New skin redness→Report nurse
ADL Care
- Bathing
- Clean to dirty
- Perineal care
- Front to back
- Dentures
- Cool labeled water
- Weak side
- Dress first
- Meal help
- Upright position
- Dysphagia
- Report swallowing trouble
- Bedpan
- Privacy and call light
- Incontinence
- Change promptly
Fire RACE
Rescue, alarm, contain, extinguish or evacuate.
RescueAlarmContainExtinguish
Report vs Chart
Report
- Urgent changes
- Tell nurse
- Before routine charting
Chart
- Objective facts
- After care
- Facility record
Urgent before routine
Care Priority Picker
- Immediate danger→Protect resident
- Fall occurred→Stay and call
- Choking signs→Call help
- Fire nearby→RACE
- New chest pain→Report now
- Breathing trouble→Report now
- Sudden confusion→Report now
- Routine observation→Chart facts
- Task outside scope→Tell nurse
Infection Control
- Hand hygiene
- Before and after
- Gloves
- Body fluid risk
- Standard precautions
- Every resident
- Dirty linen
- Away from uniform
- Sharps
- Never recap
- Isolation
- Follow posted signs
- PPE removal
- Avoid contamination
- Shared equipment
- Clean between residents
Report Now
Falls, bleeding, breathing, chest pain, sudden change.
FallsBleedingBreathingChest painSudden change
Safety + Emergency
- Call light
- Always within reach
- Bed height
- Low when unattended
- Falls
- Stay, call nurse
- Fire RACE
- Rescue alarm contain extinguish
- Choking
- Call help fast
- Seizure
- Protect from injury
- Gait belt
- Transfer support
- Wheels
- Lock before transfer
Measure + Report
- Vitals
- Compare baseline
- I&O
- Measure accurately
- Weight
- Same scale timing
- Pain
- Report resident words
- Skin
- Report redness
- Urine
- Report color changes
- Stool
- Report blood
- Charting
- Facts only
Help vs Overhelp
Help
- Cue resident
- Protect safety
- Support ability
Overhelp
- Do everything
- Reduce independence
- Ignore care plan
Support, do not replace
Restorative Care
- Independence
- Let resident try
- ROM
- Move gently
- Ambulation
- Use care plan
- Assistive device
- Keep within reach
- Contracture
- Prevent stiffness
- Pressure risk
- Reposition as ordered
- Self-care
- Cue before doing
- Overhelping
- Reduces ability
Confusion vs Delirium
Dementia
- Usually gradual
- Known baseline
- Calm redirection
Delirium
- Sudden change
- Possible emergency
- Report promptly
Gradual vs sudden
Scope Check
Assigned, trained, allowed, supervised.
AssignedTrainedAllowedSupervised
NAC vs NAR
NAC
- Certified credential
- Competency exam
- Skilled nursing eligibility
NAR
- Registered status
- Different requirements
- Not certification
Certified vs registered
Washington Flow
- Traditional graduate→Route E1
- Bridge graduate→Route E6
- Non-routine route→DOH ATT
- Credential number missing→Provider Search
- Ready for testing→Skills first
- Program has dates→Program skills
- No program date→Regional skills
- Skills passed→Credentia knowledge
- Reading barrier→Oral exam
Washington Process
- NAC
- Certified credential
- CNA
- Common search term
- NAR
- Registered status
- WABON
- Exam process guidance
- DOH
- Credentialing office
- DSHS
- OBRA registry
- Credentia
- Knowledge exam vendor
- ATT
- Authorization to Test
Skills vs Knowledge
Skills
- In-person test
- Take first
- Program or regional
Knowledge
- Online test
- Credentia
- Written or oral
Perform vs answer
Eligibility Routes
- E1
- Traditional WA graduate
- E2
- LPN/RN student
- E3
- Military nursing student
- E4
- Out-of-state training
- E5
- Lapsed after retraining
- E6
- Bridge program graduate
- E8
- OBRA reactivation
- E9
- Closed program
Routine vs Nonroutine
Routine
- E1 or E6
- WA program
- Program route
Nonroutine
- E2 through E5
- E7 through E9
- DOH authorization
Program vs review
Training + Exam Facts
- Total training
- 108 hours
- Theory
- 35 hours
- Skills lab
- 33 hours
- Clinical
- 40 hours
- Written exam
- 70 questions
- Scored items
- 60 questions
- Written limit
- 2 hours
- Oral exam
- 60 plus 10
Rights + Scope
- Privacy
- Cover and knock
- Dignity
- Respect choices
- Abuse
- Report immediately
- Neglect
- Report immediately
- Scope
- Assigned trained tasks
- Delegation
- Nurse directs care
- Care plan
- Guides assistance
- Confidentiality
- Need-to-know only
Common Traps
CNA Name
CNA common search ≠ NAC official credential
Testing Order
Skills before knowledge ≠ Out-of-order delays
Pretest Items
70 written questions ≠ 60 scored questions
Scope Boundary
Observe and report ≠ Do not diagnose
Resident Rights
Choice is respected ≠ Safety still protected
Oral Exam
Alternative format ≠ Same content knowledge
Last Minute
- 1.NAC is official credential
- 2.Skills test comes first
- 3.Credentia handles knowledge exam
- 4.Written exam has 70 MCQ
- 5.Basic nursing is 35%
- 6.Report sudden changes immediately
- 7.Protect privacy during ADLs
- 8.Care plan guides assistance
- 9.Stay within assigned scope
- 10.Answer every exam item
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