Free Kentucky CNA (SRNA) Exam Flashcards

Kentucky uses 'State Registered Nurse Aide' (SRNA) instead of 'CNA.' The title appears on the Kentucky Nurse Aide Registry maintained by the Kentucky Board of Nursing (KBN). The distinction matters because Kentucky documents, exams, employer postings, and regulations use SRNA, not CNA.

KCTCS (Kentucky Community and Technical College System) is the sole provider of SRNA testing, conducted at KCTCS campuses statewide. Kentucky is unique among states, most of which use national vendors like Prometric or Credentia, so a Kentucky candidate must test through KCTCS, not a national vendor.

A Kentucky SRNA candidate has 3 attempts to pass both the written and skills portions within 6 months of becoming eligible. Failing all 3 requires completing a new state-approved training program before retesting; the clock does not reset simply by waiting out the 6 months.

Kentucky SRNAs must work at least 8 paid hours performing nursing or nursing-related functions every 24-month period to keep their registry listing active. No continuing education hours are required; acceptable proof includes paycheck stubs, a W-2, or a notarized employer letter.

The Kentucky Board of Nursing (KBN) maintains the Nurse Aide Registry; KCTCS administers the competency exam; the Cabinet for Health and Family Services (CHFS) regulates and inspects nursing facilities. Each agency has a distinct role, so CHFS does not place a candidate on the registry and KBN does not administer the exam.

Alcohol-based hand sanitizer does NOT kill Clostridioides difficile spores; soap and water mechanically removes them. After caring for a resident with C. diff, the SRNA must wash with soap and water, because using sanitizer alone is an infection-control failure that spreads spores.

Don PPE in this order: gown first, then mask or respirator, then goggles or face shield, then gloves last (gloves go over gown cuffs). This sequence ensures the most contaminated outer layers can be removed first during doffing and protects the SRNA's hands and mucous membranes throughout care.

Remove gloves first (the most contaminated item), then face shield or goggles, then gown, then mask or N95 last. The mask is the cleanest item and is removed last to avoid contaminating the face. Perform hand hygiene immediately after all PPE is removed.

Standard Precautions treat ALL blood and body fluids (except sweat) as potentially infectious, regardless of a resident's known diagnosis. The SRNA uses gloves for anticipated contact and adds gown, mask, or eye protection based on the task's splash risk; diagnosis-based transmission-based precautions layer on top of this baseline.

Items soaked with blood or body fluids (used dressings, soiled gloves) go into a labeled red biohazard bag, not the regular trash. Per the OSHA Bloodborne Pathogen Standard and Kentucky regulations, this separation protects housekeeping staff and the public from exposure to infectious material.

An N95 respirator filters airborne particles (TB, measles, varicella) and must be fit-tested to form a tight seal; a standard surgical mask does not protect against airborne pathogens. Use N95 for known or suspected airborne infections and a surgical mask for droplet precautions such as influenza or COVID.

60-100 beats per minute is the normal adult resting pulse. A rate below 60 (bradycardia) or above 100 (tachycardia) at rest must be reported to the nurse, because the SRNA does not decide whether an out-of-range value is concerning; reporting is the SRNA's legal duty.

Axillary temperature reads about 1°F (0.5°C) lower than oral, so an axillary reading above roughly 99°F (37.2°C) suggests fever when the oral fever threshold is 100.4°F (38°C). The SRNA must know which route was used to interpret the value and report it accurately to the nurse.

Avoid taking BP on an arm with an IV line, a dialysis fistula or shunt, or on the side of a mastectomy. Compressing these arms can dislodge the IV, thrombose or damage the fistula, or cause lymphedema after mastectomy; use the opposite arm or another site.

12-20 breaths per minute is the normal adult resting range. Count a full minute (not 30 seconds multiplied by 2) when a resident has an irregular pattern, and report rates below 12 or above 20 to the nurse, because both signal respiratory compromise.

A drop of 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing indicates orthostatic hypotension. The SRNA recognizes this when a resident reports dizziness on standing, a major fall risk, and responds by assisting the resident to rise slowly and reporting the finding.

Wash from cleanest to dirtiest: face and neck first, then arms, chest, abdomen, legs, back, and the perineal area last. This progression prevents transferring microorganisms from the perineal area back to the face or to cleaner skin, which would cause cross-contamination.

Test bath water on the inside of the wrist before contact, because the wrist is sensitive to extremes and confirms water is comfortably warm (about 105-115°F or 40-46°C). Residents with diabetes or neuropathy may not feel burns, so the SRNA's wrist check is the safety check that prevents scalding.

Always wipe front to back (urethra to anus) using a fresh part of the cloth for each stroke. Wiping back-to-front drags fecal bacteria toward the urinary meatus and causes urinary tract infections, a leading cause of hospitalization and a major quality indicator in long-term care.

For a resident with hemiparesis (such as post-stroke), put the weak or affected arm into the sleeve first and undress the strong arm first. Dressing the weak side first minimizes the range of motion the weaker limb must travel, reducing pain and risk of shoulder injury.

Inspect the feet of a diabetic resident during every bath for cuts, redness, pressure sores, or fungal infection. Neuropathy means the resident cannot feel early injury, so the SRNA's visual check is the primary screening and any abnormality must be reported to the nurse immediately.

Clean the catheter and perineal area from the urethral meatus outward (away from the body) using a fresh wipe for each stroke. Cleaning toward the body pushes organisms into the bladder and raises the risk of catheter-associated urinary tract infection (CAUTI), a major infection-control concern in Kentucky nursing facilities.

Keep the bed in the lowest position when the resident is in bed or unattended, with wheels locked and the call bell within reach. The lowest position minimizes fall distance and injury, so a bed left in a raised position when the resident is unattended is an avoidable hazard the SRNA is responsible for.

The call bell must be within the resident's reach and the SRNA must remain nearby (within earshot) throughout the shower. Showers are a high-fall-risk activity; leaving a resident alone in the shower violates OBRA safety standards enforced by Kentucky CHFS and may constitute neglect.

Properly fitting non-slip footwear is a core fall-prevention measure for residents identified as fall risks. Gripper socks alone are insufficient; proper-fitting shoes with non-slip soles provide traction and prevent trips on wet or smooth floors, especially during transfers and toileting.

Physical restraints require a physician order and are a last resort; the SRNA uses alternatives first, including bed alarms, lowered bed, frequent rounding, non-slip footwear, and toileting schedules. Applying a restraint without an order violates resident rights under OBRA and is a form of abuse.

Hands clutching the throat with inability to speak or cough signals complete airway obstruction. The SRNA calls for help and begins abdominal thrusts (Heimlich) immediately; waiting for the nurse before acting can be fatal because brain death begins within minutes without oxygen.

Do NOT restrain the resident, do NOT put anything in the mouth, and do NOT move them unless in immediate danger. Restraint causes fractures, objects cause airway injury (the tongue-bite concern is a myth), and protecting the head while clearing surrounding objects is the correct action.

R = Rescue or Remove residents in immediate danger, A = Activate the alarm pull station, C = Contain the fire by closing doors, E = Extinguish if small or Evacuate. The SRNA rescues those in immediate danger first and activates the alarm before attempting to extinguish, never fighting a fire larger than wastebasket size.

Tap the shoulder firmly and call the resident's name while shouting for help and activating the emergency call system. The SRNA does not start CPR before confirming unresponsiveness and summoning the nurse or code team; checking code status (DNR) follows the initial response.

Under OBRA 1987 (enforced by Kentucky CHFS), residents may refuse any care, including baths, medications, and meals. The SRNA must respect the refusal without coercion, offer alternatives, document the refusal and what was offered, and notify the charge nurse, because forcing care is abuse under Kentucky law.

The Kentucky Long-Term Care Ombudsman Program is a federally mandated advocate for residents of nursing facilities and assisted living. Ombudsmen investigate complaints, educate residents about their rights, and cannot be retaliated against, so residents have a protected right to contact them.

Residents have the right to manage their own money, including funds held in the facility's trust account. The SRNA affirms this right and directs the resident to the appropriate staff member; the SRNA does not handle, borrow, or commingle a resident's personal funds at any time.

OBRA requires care to be delivered with privacy (close the door or curtain, expose only the area being cared for) and dignity (address by preferred name, avoid baby talk or embarrassing labels). Knocking and waiting before entering a room is both a privacy and a dignity practice the SRNA must follow.

Situation (what is happening now), Background (relevant history), Assessment (the SRNA's observation), Recommendation (what action is requested). SBAR standardizes handoff communication so the nurse receives the right information in the right order to act quickly on a change in condition.

Open-ended questions ('Tell me more about how you're feeling') invite the resident to share freely and demonstrate active listening; closed questions ('Do you have pain?') elicit yes or no answers. Therapeutic communication favors open-ended prompts, especially with residents who withdraw or feel unheard.

Draw a single line through the error, write 'error' with your initials and the date, then enter the correct information. Never erase, scratch out, or use correction fluid; a visible audit trail is legally required in medical records, and obscuring an entry looks like falsification.

Reality orientation ('Your mother has died') corrects factual errors but causes repeated grief in advanced dementia because the resident cannot retain the correction. Validation therapy acknowledges the feeling behind the words ('You miss your mama') without forcing correction, and is the recommended approach for late-stage dementia.

Sadness, crying, anger, guilt, denial, bargaining, and numbness are all normal grief reactions; grief has no fixed timeline or required sequence of stages. The SRNA listens, acknowledges the loss, and reports prolonged hopelessness or any suicidal statement to the nurse.

When a resident says 'I want to die' or 'I see no point,' the SRNA listens without judgment, does not argue or minimize ('it's not that bad'), stays with the resident, and reports immediately. These statements must always be taken seriously; false reassurance is dangerous and may delay life-saving intervention.

Moving to a nursing home is a major loss of home, independence, routines, and social roles. The SRNA's role is empathic listening: acknowledge the feeling ('It's hard to be away from home') without forcing cheer, because supportive presence is more therapeutic than problem-solving in early adjustment.

Two SRNAs use a draw sheet to move a resident up in bed: face the head of the bed, bend knees with a wide base of support, and shift weight from rear foot to front foot. The draw sheet protects the resident's skin from shear injury and the SRNA's back from strain.

Wide base of support, bend at the knees not the waist, keep the load close to the body, and never twist while lifting. These principles protect the SRNA's spine; lifting with the back bent and twisted is the leading cause of healthcare worker back injuries and is preventable.

Passive ROM is performed BY the SRNA for a resident who cannot move the joint themselves; active ROM is performed BY the resident. Both maintain joint flexibility and prevent contractures, but passive ROM also lets the SRNA observe for pain or resistance during movement that should be reported.

Kentucky Revised Statutes 209 requires reporting of adult abuse, neglect, or exploitation. The SRNA reports to the supervisor AND to Adult Protective Services (APS); the duty to report cannot be delegated to the facility, and failure to report is a misdemeanor under Kentucky law.

Kentucky SRNAs may measure vital signs, assist with ADLs, observe and report changes, and perform delegated nursing tasks under nurse supervision. They may NOT administer medications, insert or remove tubes, perform sterile procedures, or provide medical diagnoses, because these are outside SRNA scope and unsafe.

A healthcare worker may decline participation in certain procedures based on sincere religious or personal belief, but must proactively inform the supervisor so assignments can be rearranged. The SRNA cannot abandon a resident mid-shift or refuse care already in progress without arranging coverage.

Before serving a meal, verify the resident's identity using two identifiers (name and date of birth, or name and room number) and check the tray against the diet card. Wrong-patient food delivery can cause aspiration, allergic reactions, or diet-order violations such as serving a regular tray to a diabetic or dysphagia resident.

Elevate the head of the bed to at least 45 degrees, preferably closer to 90°, for any oral feeding of a resident who cannot sit in a chair. This position supports safe swallowing and prevents aspiration; lowering the HOB immediately after meals risks reflux and aspiration pneumonia.

Warm a metal bedpan, position the resident with hips on the pan, elevate the head of bed 30-45° if possible, and provide privacy. A cold bedpan causes muscle contraction and discomfort, and lack of privacy creates anxiety that may prevent the resident from voiding.