Free Nebraska CNA Exam Flashcards

A minimum of 75 hours of Nebraska DHHS-approved nurse aide training, plus one hour of Nebraska-specific abuse, neglect, and misappropriation training. A shorter 21-hour basic resident care course applies only to intermediate care facilities for the developmentally disabled. Training alone does not put you on the registry - you still have to pass both exam parts.

A written or oral exam of 50 multiple-choice questions requiring 70 percent or greater, and a clinical skills exam requiring a demonstration of six skills with 70 percent or greater on each skill. Note the count: Nebraska tests six skills, not the five that generic CNA summaries often quote. You must pass both parts to be listed on the registry.

Three opportunities to pass each exam. Fail either one three times and you must retake the 75-hour course before testing again. Once listed, you stay active by working as a nurse aide in a paid position within 24 months of your last nurse aide job; go longer and your status lapses, requiring you to pass both exams again.

Neb. Rev. Stat. 28-372 lists the nurse aide as a mandatory reporter. If you have reasonable cause to believe a vulnerable adult has been abused, neglected, or exploited, you must report it to law enforcement or to DHHS - you do not wait for permission from a supervisor. Nebraska's 24-hour Adult Abuse and Neglect Hotline is (800) 652-1999.

Physical abuse, verbal or psychological abuse, sexual abuse, financial exploitation, neglect (failing to provide needed care), involuntary seclusion, and misappropriation of resident property. Misappropriation is the one candidates forget: taking or using a resident's money or belongings without consent is a reportable finding that can be entered permanently on the nurse aide registry.

The right to be treated with dignity and respect, privacy and confidentiality, to be free from abuse, neglect, and unnecessary restraints, to make personal choices about care and daily routine, to refuse treatment, to voice grievances without retaliation, to manage personal funds, to keep and secure personal possessions, and to have visitors and participate in resident and family groups.

Knock and wait before entering, close the door and pull the privacy curtain during care, keep the resident's body covered except the area you are working on, and expose only what you need. Confidentiality means never discussing residents in hallways, elevators, break rooms, or on social media, and sharing information only with staff who need it for care.

Never for staff convenience or discipline. A restraint requires a provider's order for a specific medical reason after less restrictive alternatives fail. As a nurse aide you check the resident frequently, and release the restraint at least every two hours to reposition, toilet, offer fluids, and provide range of motion. Report any change in circulation, skin, or breathing at once.

Residents have the right to refuse care. Do not argue, bribe, or force. Explain the benefit calmly, offer an alternative time or a partial bath, respect the answer, and report the refusal to the nurse so it is documented and the care plan can be adjusted. Forcing care after a refusal can be charged as abuse.

Objective data is what you can see, hear, feel, smell, or measure: "ate 50 percent of lunch," "BP 148/92," "reddened area on left heel." Subjective data is what the resident tells you, reported in their words: "resident states her stomach hurts." Nurse aides report both but never interpret them - saying a resident "has a UTI" is diagnosing, which is outside your scope.

Face the resident at eye level, use open-ended questions ("How is your leg feeling today?" rather than "Are you okay?"), allow silence so they can finish a thought, and paraphrase back what you heard to confirm it. Avoid "why" questions, which sound accusatory, and avoid false reassurance such as "everything will be fine."

Record only after the care is finished, never before. Chart facts and measurements, not opinions. Use ink, sign with your name and title, and record the time. Correct an error by drawing a single line through it, writing the correction, and initialing - never erase, scribble out, or use correction fluid. Never chart care that someone else performed.

Lather and rub all surfaces with friction for at least 20 seconds (CDC). Keep fingertips pointed down below the wrists so water runs off the dirtiest part, wash wrists, between fingers, and under the nails, dry with a clean paper towel, then use a dry paper towel to turn off the faucet so you do not recontaminate your hands.

When hands are visibly soiled, after using the restroom, before and after eating or handling food, and after caring for a resident with Clostridioides difficile or norovirus. Alcohol does not kill C. diff spores - only the mechanical friction of soap and running water removes them. Alcohol rub is acceptable for routine hand hygiene between clean tasks.

Causative agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. The mode of transmission is the link nurse aides break most often, and hand hygiene is the single most effective way to break it - most healthcare-associated infections spread on the hands of staff moving between residents.

Treat every resident's blood, all body fluids and secretions except sweat, non-intact skin, and mucous membranes as if they are infectious - regardless of diagnosis, and for every resident, every time. They include hand hygiene, gloves for contact with body fluids, gown, mask, or eye protection when splashing is possible, and safe handling of sharps and soiled linens.

Put on: gown, then mask or respirator, then goggles or face shield, then gloves (gloves last so they cover the gown cuffs). Take off: gloves, then goggles or face shield, then gown, then mask - removing the most contaminated item first and the mask last, outside the room. Perform hand hygiene immediately after removing all PPE.

Contact precautions (MRSA, C. diff, scabies): gown and gloves for room entry, dedicated equipment. Droplet precautions (influenza, pertussis): surgical mask when working within about three to six feet of the resident. Airborne precautions (tuberculosis, measles): a fit-tested N95 respirator and an airborne infection isolation room with the door kept closed.

Do not try to stop or catch the fall - that injures you both. Widen your stance, pull her body close to yours, support her with the gait belt, and ease her down your leg to the floor while protecting her head. Then stay with her, call for the nurse, and do not move her until the nurse assesses her.

Bed in the lowest position with the wheels locked, call light and personal items within reach, floor dry and clear of clutter and cords, adequate lighting or a night light, non-skid footwear on the resident, and side rails used only if they are ordered in the care plan. Unordered side rails count as a restraint.

Partial obstruction: the resident can still cough forcefully, speak, or make noise - stay with them and encourage them to keep coughing; do not slap the back or intervene. Complete obstruction: no air movement, silent or ineffective cough, clutching the throat. Call for help and give abdominal thrusts on a conscious adult until the object clears or the person becomes unresponsive.

RACE is the response order: Rescue anyone in immediate danger, Alarm by pulling the alarm and calling out, Confine the fire by closing doors and windows, Extinguish or Evacuate as directed. PASS is how you use the extinguisher: Pull the pin, Aim at the base of the flames, Squeeze the handle, Sweep side to side.

Oxygen makes fire burn faster and hotter. No smoking, no open flames or candles, no electric razors, and no aerosol sprays or petroleum-based products such as Vaseline near the resident. Post the oxygen-in-use sign, keep the tubing untangled, and never change the flow rate - adjusting oxygen is outside the nurse aide scope of practice.

Pulse 60 to 100 beats per minute, respirations 12 to 20 breaths per minute, oral temperature about 97.6 to 99.6 degrees Fahrenheit, and oxygen saturation 95 to 100 percent. Anything outside these ranges gets reported to the nurse with the exact number and the time you took it - never rounded, never estimated.

A rectal temperature reads about one degree Fahrenheit higher than oral, and an axillary temperature reads about one degree lower than oral - so the same resident could measure 98.6 orally, 99.6 rectally, and 97.6 axillary. Axillary is the least accurate site. Always document the site with the reading, because the number is meaningless without it.

Using a cuff that is too small falsely raises the reading; letting the arm hang below heart level does the same. Support the arm at heart level, apply the cuff snugly about an inch above the elbow, and deflate slowly. Never take a blood pressure on an arm with an IV, a dialysis access site, a cast, or on the side of a mastectomy.

Take an apical pulse when the radial pulse is weak or irregular, when the resident takes heart medication, or when the nurse directs it. Place the stethoscope over the apex of the heart - the left side, fifth intercostal space at the midclavicular line - and count for one full minute. Count irregular radial pulses for a full minute as well.

Breathing is partly under voluntary control, so people change their rate once they know you are watching. Keep your fingers on the wrist as if you were still taking the pulse and count the rise and fall of the chest. One rise plus one fall equals one respiration. Count a full minute if the pattern is irregular, shallow, or noisy.

One ounce equals 30 milliliters, and a standard 8-ounce cup equals 240 milliliters. Half of a 240 mL cup of juice is recorded as 120 mL. Measure output in a graduate on a flat surface at eye level, record intake and output separately in milliliters, and report to the nurse when output is far less than intake.

Same scale, same time of day, same amount of clothing, no shoes, after the resident voids, with the scale balanced at zero first. Otherwise a "weight change" is really a measurement error. Report a gain or loss of roughly three pounds or more in a week, or any amount the care plan specifies, because sudden gain can signal fluid retention.

Chest pain, difficulty breathing or a change in breathing pattern, a sudden change in mental status or new confusion, bleeding, a fall, a vital sign outside the normal range, any new reddened or broken skin area, a change in level of consciousness, or a resident's complaint of severe pain. Report facts and exact times; do not wait for the resident to look worse.

Water around 105 degrees Fahrenheit (about 40.5 Celsius) - check it and let the resident confirm it feels comfortable, because older and diabetic residents may not sense a burn. Wash from cleanest to dirtiest: eyes first with a different corner of the washcloth for each eye, wiping inner to outer, then face, arms, chest, abdomen, legs, and perineum last.

Always wipe front to back, away from the urethra, to keep rectal bacteria out of the urinary tract, using a clean area of the cloth for each stroke. For a female resident, separate the labia and clean the middle then each side. For an uncircumcised male, retract the foreskin, clean the tip in a circular motion moving outward, then return the foreskin to position.

The weak (affected) side is dressed first and undressed last. Dressing the strong arm first would force you to stretch the weak limb through the sleeve, which risks pain and injury. Memory hook: weak goes in first, weak comes out last. Support the joint above and below while you move the limb, and let the resident choose the clothing.

Sit the resident fully upright at about 90 degrees, chin tucked slightly toward the chest, never lying back. Offer small bites and alternate solids with sips, check that the mouth is empty before the next bite, use thickened liquids only if ordered, and keep the resident upright for at least 30 minutes after the meal. Report coughing, wet voice, or pocketed food.

Reposition at least every two hours, keep skin clean and dry, smooth out wrinkles in linens, float the heels, and provide adequate fluids and nutrition. Never massage over a bony prominence or a reddened area - it damages tissue further. A stage 1 injury is intact skin with redness that does not blanch (turn white) when pressed. Report it immediately.

Keep the drainage bag below the level of the bladder at all times and never on the floor, so urine cannot flow back. Keep the tubing free of kinks and secure it to the thigh to prevent pulling. Never disconnect the tubing from the bag. Clean about four inches of the catheter from the meatus outward, and measure and record output.

Feet apart about shoulder width for a wide base of support, bend at the knees and hips rather than the waist, keep your back straight and the load close to your body, use your leg muscles to lift, and pivot with your feet instead of twisting your spine. Push, slide, or roll rather than lift, and get help or a mechanical lift for heavy transfers.

Apply it over clothing, never on bare skin, snugly around the waist so you can slip a flat hand underneath, with the buckle off center and away from the spine. Grasp it with an underhand grip. Do not use one on a resident with abdominal or back surgery, a colostomy, a feeding tube, fractured ribs, severe cardiac or respiratory disease, or advanced pregnancy.

Position the chair on the resident's stronger side at a slight angle, lock the wheels, raise or remove the footrests, and lower the bed so the feet are flat on the floor. Apply the gait belt, let the resident sit on the edge of the bed until dizziness passes, block the weak knee and foot with yours, then move on a counted signal.

Two staff members are required. Verify the sling is the right size and free of frays, that every hook or strap is fastened and the loops are even, and that the lift's weight capacity covers the resident. Lock the base or wheels as directed, have the resident cross their arms over the chest, raise slowly, and keep the resident low while moving.

Supine (flat on the back), prone (on the abdomen), lateral (side-lying), and Sims' (left side, semi-prone). Fowler's raises the head of the bed roughly 45 to 60 degrees; semi-Fowler's about 30 to 45; high Fowler's about 60 to 90. Reposition a resident in bed at least every two hours, and one sitting in a chair at least every hour.

Passive ROM: you move the joint because the resident cannot. Active ROM: the resident does it independently while you supervise. Active-assistive: the resident starts the movement and you help finish it. The care plan and the nurse decide which type applies - performing passive ROM on a resident who can do it themselves works against restorative goals.

Support the limb above and below the joint, move slowly and smoothly through the joint's normal range, and stop at the point of resistance or pain - never force a joint past it. Repeat each movement the number of times the care plan specifies. Report pain, new stiffness, or a joint that will not move as far as it did before.

The cane goes in the hand on the resident's strong (unaffected) side, and the cane or walker moves forward first, then the weak leg, then the strong leg. You stand slightly behind and to the weak side holding the gait belt. Check that walker tips and cane tips have intact rubber ends and that the device is at hip height.

Approach from the front so you do not startle them, make eye contact, identify yourself and use their name each time, and give one short simple instruction at a time. Do not argue, quiz them about the date, or correct a false belief - it raises anxiety without improving memory. Use redirection and validate the feeling behind what they are saying.

Increased confusion, restlessness, and agitation that appears in the late afternoon and evening. Help by increasing light before dusk, closing blinds to reduce shadows and glare, keeping the routine and caregivers consistent, reducing noise and stimulation, avoiding caffeine late in the day, and offering a calm familiar activity. Report a new or worsening pattern to the nurse.

Stop the task and step back to a safe distance. Stay calm, keep your voice low and slow, do not restrain or corner them, and remove the trigger - noise, a crowded room, an unfamiliar face. Ensure the resident and others are safe, then reapproach later or let another aide try. Report the episode and what preceded it so triggers can be identified.

The need to feel useful, to keep familiar routines and possessions, to stay connected to family and faith, and to make personal choices about when to get up, what to wear, and what to eat. Ask about customary routines rather than imposing the facility's schedule, involve family as a source of emotional support, and arrange privacy for prayer, clergy visits, or religious practices.

Report withdrawal from activities, loss of appetite, sleeping much more or less, crying, expressions of hopelessness or worthlessness, and any statement about wanting to die - treat that last one as urgent. Depression can mimic dementia with slowed thinking and poor concentration, but it often comes on quickly and, unlike dementia, is treatable. Reporting it is what gets it evaluated.