Free Maryland CNA Exam Flashcards

The Maryland Board of Nursing regulates nursing assistant certification, while Credentia or D&SDT-Headmaster gives the competency evaluation. MBON controls the credential; the testing vendor runs the exam.

Maryland candidates complete a knowledge exam and a skills evaluation. The knowledge test checks nurse aide concepts; the skills test checks safe step-by-step performance of assigned care tasks.

Since April 1, 2026, a CNA-I can work in any setting, including a nursing facility or skilled nursing facility. A CNA-II cannot work in a nursing facility or skilled nursing facility. New applicants can only become CNA-I, and there is no separate GNA designation.

It is the federal 4-month rule (42 CFR 483.35(d)): a nursing facility may not use someone as a nurse aide for more than 4 months full-time unless they have completed training and a competency evaluation. CMS told the Maryland Board of Nursing there is no waiver.

The candidate must complete a Maryland Board of Nursing-approved nursing assistant training program. Flashcards help review, but they do not replace the required approved training pathway.

Renew every 2 years by the 28th of your birth month, pay the $40 fee, and show at least 16 hours of paid work as a nursing assistant in the 2 years before expiry. Without those hours, a CNA-I must pass the competency evaluation again.

A CNA provides delegated basic care and reports observations. Assessment, diagnosis, care-plan creation, medication decisions, and treatment changes belong to licensed nursing staff or providers.

Decline the unsafe task respectfully and report it to the nurse. Performing a task outside scope can harm the resident and can also put the CNA's certification at risk.

The nurse assesses, plans, and updates care. The CNA follows the care plan and reports changes that may require the nurse to reassess.

Report sudden pain, chest pain, shortness of breath, falls, new confusion, bleeding, abnormal vital signs, skin breakdown, choking, or major behavior changes. The CNA observes; the nurse decides the clinical response.

Objective information is observed or measured, such as pulse rate or drainage color. Subjective information is what the resident says. Chart facts clearly and avoid opinions, blame, or diagnosis.

Share resident information only with staff who need it for care, and only in appropriate settings. Gossip, hallway discussions, social media posts, and unnecessary disclosures violate privacy.

Respect the refusal, try to understand the concern, and report it to the nurse. Forcing care violates resident rights; ignoring the refusal without reporting can also be unsafe.

Close doors or curtains, keep the resident covered, expose only the area being washed or dressed, and explain what you are doing. Privacy is a resident right, not a courtesy extra.

Make sure the resident is safe and tell the nurse or supervisor immediately. Maryland law (Health-General §19-347) also says anyone who believes a resident has been abused reports promptly to the police and the Office of Health Care Quality. CNAs do not investigate or confront.

Call for help and stay with the resident. Do not move the resident until the nurse assesses for injury unless there is immediate danger, because moving can worsen an unseen injury.

Only when a physician authorizes it for a clearly indicated medical need (Maryland Health-General §19-343) and it is in the care plan, with required monitoring. A CNA cannot use restraints for convenience, punishment, staffing problems, or to make care easier.

Make sure the call light and needed items are within reach, the bed is low and locked, and the resident is positioned safely. These basics prevent falls and unmet needs.

Perform hand hygiene before and after resident contact, after removing gloves, after contact with body fluids, before clean tasks, after dirty tasks, and whenever moving from contaminated to clean care.

Use soap and water when hands are visibly soiled and for organisms such as C. difficile. Alcohol sanitizer is useful only when hands are not visibly dirty and the organism is appropriate.

Standard precautions apply to every resident. Treat blood and body fluids as potentially infectious, use hand hygiene, wear PPE when exposure is possible, and handle sharps and linens safely.

Contact precautions focus on touch and contaminated surfaces, so gown and gloves are central. Droplet precautions focus on respiratory droplets during close care, so a mask is key.

Airborne precautions are for tiny particles that remain suspended and travel farther. They require special room controls and respiratory protection beyond a routine surgical mask.

The dirtiest items should come off first so contamination does not spread to skin, clothing, or clean surfaces. Hand hygiene after PPE removal closes the safety loop.

Work from clean areas toward dirtier areas, keeping the resident covered between steps. This protects dignity and reduces the chance of carrying organisms from contaminated areas to cleaner skin.

Clean from front to back, use clean areas of the washcloth, and change supplies when contaminated. The goal is to prevent organisms from being moved toward the urinary tract.

Position the resident on the side with the head turned so fluid can drain. This protects the airway; lying flat increases aspiration risk.

Inspect, clean, dry, and report problems, but do not cut diabetic toenails. Small cuts can become serious because diabetes can impair circulation and sensation.

Dress the weaker or affected side first and undress the stronger side first. This reduces pulling, pain, and injury because the stronger side can help more with the final movement.

Handle dentures over a towel-lined basin, brush them gently, rinse as directed, and store them safely. The towel reduces breakage if they slip.

Seat the resident upright, offer small bites, allow time to swallow, follow the care plan, and stop if coughing, choking, wet voice, or distress appears. Report swallowing problems promptly.

Thickened liquids slow the flow of fluid for residents with dysphagia. Giving thin liquids against the care plan can lead to choking or aspiration.

Intake includes fluids taken by mouth and other ordered liquid sources. Output includes urine, emesis, drainage, and other measurable fluid losses. Accurate I&O helps the nurse judge hydration and fluid balance.

Provide privacy, clean the resident, dispose of waste safely, remove gloves, perform hand hygiene, and report abnormal stool, urine, pain, blood, or difficulty. Elimination changes can signal illness.

Count respirations without making the resident overly aware, because people may change breathing when watched. Assess rate, rhythm, effort, and unusual sounds or shortness of breath.

Assess rate, rhythm, and strength as trained. Irregular, very weak, very fast, very slow, or unexpectedly changed pulses should be reported to the nurse.

Systolic is the pressure when the heart contracts. Diastolic is the pressure when the heart rests between beats. Both matter because abnormal readings can signal cardiovascular or fluid problems.

For an adult, gently pull the ear up and back to help straighten the ear canal. The goal is correct probe alignment, not force.

Recheck if appropriate, make sure the measurement was taken correctly, and report the finding to the nurse. Do not diagnose or decide that an abnormal value is unimportant.

Explain the move, lock bed and wheelchair brakes, place the resident's footwear, use the gait belt if care-planned, count before moving, and keep the resident close to your center of gravity.

A gait belt gives the caregiver a secure handhold during transfers or ambulation. It is not used to lift by force, restrain the resident, or replace proper body mechanics.

Assistive devices must match the care plan and resident ability. A cane usually supports the weaker side from the stronger hand; a walker moves first, then the resident steps into it.

Move joints gently through the allowed range and stop for pain, resistance, or unusual change. ROM maintains mobility, but forcing a joint can injure the resident.

Repositioning relieves pressure, protects bony areas, and supports circulation. Report redness, open areas, pain, or skin that does not return to normal after pressure relief.

Fowler's means the head of the bed is elevated, often for breathing or eating. Lateral means side-lying, often used for pressure relief or safer drainage during certain care.

Use a wide base of support, bend at the knees, keep the load close, face the direction of movement, and avoid twisting. Good mechanics protect both CNA and resident.

Use calm tone, short statements, reassurance, and redirection. Arguing about reality usually increases distress; safety and emotional comfort come first.

Use simple sentences, allow extra time, offer communication aids if available, and avoid pretending to understand. Aphasia affects communication, not necessarily intelligence.

Ask about preferences, avoid assumptions, protect privacy, and follow the care plan. Culture, religion, diet, modesty, and end-of-life practices can all affect daily care.

Help the resident do as much as safely possible rather than doing everything for them. Restorative care protects independence, dignity, mobility, and confidence.