Illinois CNA Exam Flashcards

Q: Who administers the Illinois CNA exam?

The Illinois Nurse Assistant Competency Exam (INACE) is administered by Southern Illinois University Carbondale (SIUC) for the Illinois Department of Public Health (IDPH). Unlike most states, Illinois does not use Prometric or Credentia. You register at inace.nurseaidetesting.com and must pass both an 85-question written test (90 minutes) and a clinical skills evaluation.

Q: What is the Illinois Health Care Worker Registry (HCWR)?

The HCWR, maintained by IDPH, is the official database verifying CNA status in Illinois. After you pass the INACE, your name is added within about 2 weeks (viewable at hcwrpub.dph.illinois.gov). Substantiated findings of abuse, neglect, or theft are also recorded there and can bar employment.

Q: How much training does Illinois require to become a CNA?

Illinois requires completion of an IDPH-approved Basic Nurse Assistant Training Program (BNATP). The federal OBRA minimum of 75 hours applies under Illinois Administrative Code Title 77, Part 395, combining classroom instruction and supervised clinical practice before you can schedule the INACE.

Q: What happens if my Illinois CNA certification lapses?

If you do not perform qualifying nurse aide work for 24 consecutive months, your certification lapses. If you are in good standing (no abuse/neglect/theft findings), you may recertify by competency testing only - you do not have to repeat training. Contact SIUC Nurse Aide Testing to start the process.

Q: How do Illinois CNAs report suspected abuse?

Illinois CNAs are mandatory reporters under the Abused and Neglected Long Term Care Facility Residents Reporting Act (210 ILCS 30). You must report suspected abuse, neglect, or exploitation immediately to your charge nurse or supervisor; the facility then reports to IDPH. A substantiated finding is noted on the HCWR.

Q: What is the passing standard for the Illinois INACE written exam?

The written portion uses a scaled score set by IDPH, generally equivalent to roughly 70% correct. You must pass both the written exam and the clinical skills evaluation; each skill step must be performed correctly because partial credit is not awarded on the skills test.

Question 1

INACE

Accepted Answer

The Illinois Nurse Assistant Competency Exam - Illinois's own state CNA test administered by SIUC for IDPH, not the national Prometric NNAAP. It has an 85-question written portion plus a hands-on clinical skills evaluation.

Question 2

Health Care Worker Registry (HCWR)

Accepted Answer

The IDPH-maintained database that verifies CNA status in Illinois. You are listed about 2 weeks after passing the INACE. Employers check it before hiring; abuse/neglect findings are flagged here.

Question 3

BNATP (Basic Nurse Assistant Training Program)

Accepted Answer

The IDPH-approved training you must complete before testing. Illinois follows the federal OBRA minimum of 75 hours (Title 77, Part 395), combining classroom and supervised clinical hours.

Question 4

Lapsed CNA recertification in Illinois

Accepted Answer

If you go 24+ consecutive months without qualifying nurse aide work, your certification lapses. If in good standing, you recertify by competency testing only - no retraining required.

Question 5

Illinois CNA mandatory reporting

Accepted Answer

Under 210 ILCS 30, CNAs must immediately report suspected abuse, neglect, or exploitation to the charge nurse/supervisor; the facility reports to IDPH. Failure to report is a legal violation.

Question 6

Activities of Daily Living (ADLs)

Accepted Answer

Basic self-care tasks: bathing, dressing, grooming, toileting, transferring, and eating. CNAs assist only as needed to preserve resident independence - never do for residents what they can do themselves.

Question 7

Dressing a resident with a weak (affected) side

Accepted Answer

Dress the weak/affected side FIRST and undress it LAST. This avoids forcing the impaired limb through clothing and reduces pain and injury risk.

Question 8

Perineal care direction

Accepted Answer

Always clean from front to back (cleanest to dirtiest) to prevent moving bacteria from the rectal area toward the urethra, which causes urinary tract infections. Use a clean section of the cloth for each stroke.

Question 9

Water temperature for resident bathing

Accepted Answer

Check bath water before use - roughly 105°F (about 41°C) is a typical safe range. Always test temperature and ask the resident; aging skin and reduced sensation increase burn risk.

Question 10

Oral care for an unconscious resident

Accepted Answer

Turn the resident's head to the side and position them on their side to prevent aspiration. Use minimal fluid and a swab; never insert objects between clenched teeth.

Question 11

Normal adult vital sign ranges

Accepted Answer

Temperature ~97-99°F oral, pulse 60-100 bpm, respirations 12-20/min, blood pressure under 120/80. Report values outside these ranges to the nurse.

Question 12

Objective vs. subjective data

Accepted Answer

Objective data is measurable and observed (BP 150/90, redness, refused meal). Subjective data is what the resident states ('I feel dizzy'). CNAs report both accurately but do not interpret or diagnose.

Question 13

When should a CNA report a change of condition?

Accepted Answer

Immediately. Any new or worsening sign - chest pain, confusion, fall, skin breakdown, refusal to eat, abnormal vitals - must be reported to the nurse right away, not at end of shift.

Question 14

Measuring an apical pulse

Accepted Answer

Listen with a stethoscope at the apex of the heart for a FULL 60 seconds. Used for irregular rhythms or before certain cardiac medications - more accurate than a radial pulse.

Question 15

Intake and Output (I&O)

Accepted Answer

Measured record of all fluids taken in (oral, IV, tube) and put out (urine, emesis, drainage). Reported in mL. Significant imbalance signals dehydration or fluid overload and must be reported.

Question 16

Standard Precautions

Accepted Answer

Infection control used for ALL residents regardless of diagnosis. Treat all blood and body fluids as infectious: hand hygiene, gloves, and other PPE whenever contact is anticipated.

Question 17

Most effective way to prevent infection spread

Accepted Answer

Hand hygiene. Wash with soap and water for at least 20 seconds; use soap and water (not alcohol gel) when hands are visibly soiled or after caring for a resident with C. diff.

Question 18

Order for donning and removing PPE

Accepted Answer

Don: gown, mask, goggles, gloves. Remove: gloves, goggles, gown, mask (gloves are dirtiest and come off first). Hand hygiene follows removal.

Question 19

Medical vs. surgical asepsis

Accepted Answer

Medical asepsis (clean technique) reduces the number of microorganisms - routine CNA care. Surgical asepsis (sterile technique) eliminates all microorganisms - used for invasive procedures by licensed staff.

Question 20

Airborne vs. droplet vs. contact precautions

Accepted Answer

Airborne (TB, measles, varicella): negative-pressure room + N95. Droplet (influenza, pertussis): private room + surgical mask within ~6 ft. Contact (C. diff, MRSA): gown + gloves, dedicated equipment.

Question 21

OBRA 1987

Accepted Answer

Federal Omnibus Budget Reconciliation Act establishing nursing home resident rights, the 75-hour training minimum, and competency testing for nurse aides. Illinois resident rights derive from OBRA.

Question 22

Illinois Nursing Home Care Act (210 ILCS 45)

Accepted Answer

Illinois law governing resident rights and protections in licensed nursing homes - dignity, privacy, freedom from abuse, grievance procedures, and participation in care planning.

Question 23

Resident's right to refuse care

Accepted Answer

Residents may refuse any treatment or care. The CNA stops, does not argue or force, and reports the refusal to the nurse so it can be documented and addressed.

Question 24

Protecting resident privacy and dignity

Accepted Answer

Knock before entering, close doors and curtains, drape during care, expose only the body area being worked on, and keep personal/health information confidential (HIPAA).

Question 25

Types of abuse a CNA must recognize

Accepted Answer

Physical, verbal/psychological, sexual, financial/material exploitation, and neglect (including involuntary seclusion). Unexplained bruises, fear, or sudden behavior change are warning signs.

Question 26

Proper body mechanics

Accepted Answer

Bend at the knees and hips (not the waist), keep the back straight, hold the load close to your body, and use a wide base of support. Push or pull rather than lift when possible.

Question 27

RACE (fire response)

Accepted Answer

Rescue residents in danger, Activate the alarm, Contain the fire by closing doors/windows, Extinguish or Evacuate. Rescue always comes first.

Question 28

PASS (fire extinguisher use)

Accepted Answer

Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side. Used only on small, contained fires after residents are safe.

Question 29

Fall prevention basics

Accepted Answer

Keep the bed in the lowest position, lock wheels before transfers, ensure call light is in reach, use nonslip footwear, keep pathways clear, and answer call lights promptly.

Question 30

Restraint-free / least-restraint policy

Accepted Answer

Restraints are a last resort, require a provider order, and can cause injury, depression, and loss of mobility. Always try alternatives (toileting schedules, activity, repositioning) first.

Question 31

Transferring a resident with a transfer belt

Accepted Answer

Apply the gait/transfer belt over clothing at the waist, grip underhand from below, transfer toward the resident's strong side, and block their knees with yours to prevent buckling.

Question 32

Logrolling

Accepted Answer

Turning a resident as one unit while keeping the spine straight, used after spinal injury or surgery. Requires two or more staff and a draw sheet to move head, trunk, and legs together.

Question 33

Fowler's position

Accepted Answer

Head of bed raised 45-60° (high Fowler's up to 90°). Used for breathing difficulty, eating, and to reduce aspiration risk during and after meals.

Question 34

Repositioning schedule for bedbound residents

Accepted Answer

Reposition at least every 2 hours to prevent pressure injuries. Bony prominences (sacrum, heels, hips) need pressure relief; report any reddened area that does not fade.

Question 35

Range of motion (ROM) - active vs. passive

Accepted Answer

Active ROM: the resident moves the joint themselves. Passive ROM: the CNA moves the joint for a resident who cannot. Move slowly to just before the point of pain; never force.

Question 36

Purpose of restorative care

Accepted Answer

To help residents regain or maintain the highest level of function and independence - ambulation programs, ROM, bladder/bowel training - and to prevent complications like contractures.

Question 37

Contracture

Accepted Answer

Permanent shortening and tightening of a muscle or joint from disuse, leading to deformity and loss of motion. Prevented by ROM exercises, proper positioning, and regular activity.

Question 38

Using a cane or walker safely

Accepted Answer

The resident holds a cane on the strong side and advances the cane and weak leg together. Stand on the weak side to assist. A walker must have all legs on the ground before stepping.

Question 39

Communicating with a hearing-impaired resident

Accepted Answer

Face the resident at eye level, reduce background noise, speak clearly at a normal pace, use short sentences, and confirm understanding. Do not shout - it distorts speech.

Question 40

SBAR

Accepted Answer

A structured report format: Situation, Background, Assessment, Recommendation. CNAs use the Situation and Background portions to report observations clearly to the nurse.

Question 41

Documentation rule for CNAs

Accepted Answer

Chart only what you did and observed, factually and promptly, after care is given (never before). Correct errors with a single line and initials - do not erase or use white-out.

Question 42

Therapeutic communication techniques

Accepted Answer

Use open-ended questions, active listening, silence, and reflection. Avoid false reassurance ('Everything will be fine'), giving advice, or changing the subject.

Question 43

Caring for a resident with dementia who is agitated

Accepted Answer

Stay calm, approach from the front, use a soft voice, remove triggers, and redirect to a familiar activity. Do not argue or correct delusions - validate feelings and ensure safety.

Question 44

Sundowning

Accepted Answer

Increased confusion, agitation, and restlessness in the late afternoon or evening, common in dementia. Reduce noise, increase lighting before dusk, and maintain a consistent routine.

Question 45

Recognizing depression in older adults

Accepted Answer

Signs include withdrawal, appetite or sleep changes, loss of interest, fatigue, and expressions of hopelessness. CNAs observe and report these to the nurse - they do not diagnose or counsel.

Question 46

Supporting cultural and spiritual needs

Accepted Answer

Respect dietary, religious, and cultural practices; allow privacy for prayer; do not impose personal beliefs. Accommodate preferences within the care plan whenever possible.

Question 47

Aspiration prevention during feeding

Accepted Answer

Position the resident upright at 90°, give small bites, alternate solids and liquids, allow time to chew/swallow, and keep them upright 30+ minutes after eating. Stop and report any coughing or choking.

Question 48

Signs of dehydration

Accepted Answer

Dry mouth, dark concentrated urine, low output, dry skin, confusion, and dizziness. CNAs encourage fluids per the care plan, monitor I&O, and report concerns to the nurse.

Question 49

Indwelling catheter care

Accepted Answer

Keep the drainage bag below bladder level, secure tubing without kinks, never let the bag touch the floor, and provide perineal care. Report cloudy urine, leakage, or no output.

Question 50

Promoting normal elimination and continence

Accepted Answer

Offer regular toileting schedules, provide privacy and adequate time, encourage fluids and fiber, and respond to call lights quickly. Never scold a resident for incontinence.

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