New York CNA Exam Flashcards

Q: How many questions are on the New York CNA written exam?

The New York CNA written exam has approximately 70 multiple-choice questions (60 scored, 10 pretest) with 90 minutes to complete. The clinical skills evaluation tests 5 randomly selected skills and takes about 30 minutes. You must pass both portions.

Q: What is the passing score for the New York CNA exam?

You need 70% on the written exam (42 of 60 scored questions) and must perform all critical steps correctly on every tested clinical skill. Missing any critical step on a skill results in failure of that skill, regardless of other steps performed correctly.

Q: How many training hours does New York require?

New York requires a minimum of 100 hours of state-approved nurse aide training: 30 hours classroom and 70 hours supervised clinical. This exceeds the federal OBRA minimum of 75 hours by 25 hours. Programs must be approved by NYSDOH.

Q: Who administers the New York CNA exam?

Prometric administers the New York CNA competency exam on behalf of the New York State Department of Health (NYSDOH). First-time tester fee is $115 (written + skills) or $135 (oral + skills). Schedule through Prometric at prometric.com/exams/nurseaide-ny.

Q: How long do I have to pass after training?

New York allows 24 months from training completion to pass both written and clinical skills portions. If you do not pass within 24 months, you must complete a new state-approved training program before retesting. Individual portion retakes cost $57 (written), $68 (skills), or $67 (oral).

Q: How do I maintain New York CNA certification?

After passing, your name is placed on the NYSDOH Nurse Aide Registry. Certification is valid for 24 months. To maintain active status, you must perform at least 7 hours of paid nursing-related work in a NYS nursing home during each 24-month period and complete required in-service training.

Question 1

New York 100-hour training requirement

Accepted Answer

NYSDOH mandates minimum 100 hours of approved nurse aide training: 30 classroom + 70 clinical. Exceeds the federal OBRA minimum of 75 hours. Training must be completed within 24 months before testing and from a NYSDOH-approved program.

Question 2

Prometric NY CNA exam structure

Accepted Answer

Two portions: written exam (60 scored + 10 pretest questions, 90 minutes, 70% to pass) and clinical skills (5 randomly selected skills, ~30 minutes, all critical steps must be correct). Must pass both; retake only the failed portion.

Question 3

NY CNA exam fees

Accepted Answer

First-time: $115 (written + skills) or $135 (oral + skills with reading comprehension). Retakes: $57 written, $68 skills, $67 oral. Contact Prometric at 800-805-9128 for scheduling.

Question 4

24-month testing window

Accepted Answer

Candidates have 24 months from training completion to pass both exam portions. Failure to pass within this window requires completing a new NYSDOH-approved training program before retesting — the window does not simply reset.

Question 5

NYSDOH Nurse Aide Registry

Accepted Answer

After passing both portions, your name is automatically placed on the registry. Certification valid 24 months. Maintained by NYSDOH; Prometric administers the exam but does not manage registry listings.

Question 6

NY CNA recertification requirement

Accepted Answer

Perform at least 7 hours of paid nursing-related services in a NYS nursing home during each 24-month period to maintain active registry status. Employers typically handle renewal fees ($40). Without paid work, you must retest or retrain.

Question 7

Fingerprint-based background check

Accepted Answer

Required for all nursing home CNAs in New York. Criminal history record check through NYSDOH before employment. CNAs with findings of abuse, neglect, or misappropriation on any state registry are barred from registry listing.

Question 8

Mandated reporting (New York)

Accepted Answer

CNAs are mandated reporters who must immediately report suspected abuse, neglect, or misappropriation of resident property to the charge nurse or supervisor. Failure to report can result in criminal liability and registry removal.

Question 9

CNA scope of practice (New York)

Accepted Answer

CNAs may perform tasks delegated by licensed nurses: ADLs, vital signs, positioning, transfers, ROM, intake/output, and observation/reporting. CNAs cannot administer medications, insert catheters, interpret diagnoses, or perform sterile wound care independently.

Question 10

Chain of command

Accepted Answer

CNAs report changes in resident condition, safety concerns, and care issues to the charge nurse or supervisor — not directly to physicians or families for clinical decisions. Follow facility chain of command; good-faith reporting is protected from retaliation.

Question 11

Activities of Daily Living (ADLs)

Accepted Answer

Basic self-care: bathing, dressing, grooming, eating, toileting, transferring, and continence management. CNAs assist at levels of independent, supervised, assist, or total care. Document the assistance level provided.

Question 12

Normal vital sign ranges

Accepted Answer

Temperature: 97.6–99.6°F oral. Pulse: 60–100 bpm. Respirations: 12–20/min. Blood pressure: ~120/80 mmHg. Report any abnormal values immediately to the nurse — do not wait until end of shift.

Question 13

Body mechanics

Accepted Answer

Use the body efficiently to prevent injury: wide base of support, bend at knees (not waist), keep back straight, hold load close to body, pivot feet instead of twisting spine. Foundation for all transfers and repositioning.

Question 14

Mechanical lift transfer

Accepted Answer

Use for residents who cannot bear weight or assist. Check sling size and attachment points, ensure two staff when required, raise slowly, and never leave a resident suspended in the lift. Follow facility policy and manufacturer instructions.

Question 15

Fowler's position

Accepted Answer

Semi-sitting position with head of bed elevated 45–60 degrees. Used for eating, breathing ease, and certain treatments. High Fowler's (90 degrees) for oral care and feeding; low Fowler's (30 degrees) for comfort.

Question 16

Lateral (side-lying) position

Accepted Answer

Resident lies on side with pillows supporting head, back, and upper leg. Used to prevent pressure ulcers and for perineal care access. Alternate sides per care plan — never leave on one side indefinitely.

Question 17

Range of motion (ROM) exercises

Accepted Answer

Moving joints through full movement to maintain mobility and prevent contractures. Perform active ROM if resident can move independently; passive ROM if resident cannot. Stop if resident reports pain and report to nurse.

Question 18

Intake and output (I&O)

Accepted Answer

Measuring and recording all fluids consumed and eliminated. Critical for monitoring fluid balance in residents with heart failure, kidney disease, or dehydration risk. Record in milliliters on the I&O sheet per facility protocol.

Question 19

Pressure ulcer (decubitus) prevention

Accepted Answer

Reposition at least every 2 hours, keep skin clean and dry, use pressure-relief devices, ensure adequate nutrition and hydration, and report any redness (stage 1) immediately. Never massage over bony prominences.

Question 20

Catheter care (indwelling)

Accepted Answer

Cleanse around the meatus and catheter tubing during perineal care using facility-approved solution. Keep drainage bag below bladder level, do not pull on catheter, and report cloudy urine, absence of drainage, or signs of infection.

Question 21

Hand hygiene (clinical skills)

Accepted Answer

Always tested and observed throughout the NY clinical skills exam. Wash with soap and water for at least 20 seconds, covering all surfaces. Performed before and after resident contact, after removing gloves, and between skills.

Question 22

C. difficile and hand hygiene

Accepted Answer

Alcohol-based hand sanitizer does NOT kill C. difficile spores. Must use soap and water to mechanically remove spores after caring for a C. diff resident. Using sanitizer alone spreads spores to other residents.

Question 23

Standard Precautions

Accepted Answer

Applied to ALL residents regardless of diagnosis. Includes hand hygiene, PPE when contact with blood/body fluids is anticipated, safe injection practices, and treating all blood/body fluids as potentially infectious.

Question 24

PPE donning order

Accepted Answer

Gown first, then mask or respirator, then goggles or face shield, then gloves. Covers torso, secures ties, adjusts fit. Don before entering the resident's room or care area when isolation precautions are in effect.

Question 25

PPE removal (doffing) order

Accepted Answer

Gloves first (most contaminated), then goggles/face shield, then gown, then mask/respirator. Perform hand hygiene immediately after removal. Never touch clean surfaces with contaminated gloves.

Question 26

Contact Precautions

Accepted Answer

For pathogens spread by direct or indirect contact: C. diff, MRSA, VRE, scabies. Requires gown and gloves for all resident contact, dedicated equipment, and private room when possible.

Question 27

Perineal care sequence

Accepted Answer

Explain procedure, provide privacy, wash hands, don gloves. For females: clean front to back (urethra toward anus) to prevent UTI. Use clean washcloth sections for each stroke. Pat dry gently and report redness or discharge.

Question 28

Partial bed bath order

Accepted Answer

Wash face first (no soap on face), then arms, chest, abdomen, legs, back, and perineal area last (most contaminated). Use clean washcloth for each body area. Maintain privacy and warmth throughout.

Question 29

Oral hygiene for unconscious resident

Accepted Answer

Position resident on side to prevent aspiration. Use small amounts of water or mouth moisturizer, not full rinsing. Clean teeth and gums gently, remove dentures for cleaning, and never leave an unconscious resident flat on their back during care.

Question 30

Feeding assistance

Accepted Answer

Sit resident upright (Fowler's position), offer small bites, allow chewing and swallowing between bites, check for pocketing food in cheeks, and stop if coughing or choking occurs. Report swallowing difficulty to the nurse.

Question 31

Resident rights (OBRA)

Accepted Answer

Federal rights include dignity, privacy, freedom from abuse/restraint, participation in care planning, grievance without retaliation, and access to personal belongings. NYSDOH enforces these in all certified nursing facilities.

Question 32

Right to refuse care

Accepted Answer

Competent residents may refuse any treatment or personal care. The CNA must respect the refusal, notify the nurse immediately, and document the refusal. Cannot force care unless a safety emergency exists and policy allows intervention.

Question 33

HIPAA and resident privacy

Accepted Answer

Protected health information (PHI) cannot be shared with unauthorized persons — including other residents' families, visitors, or staff without need to know. Discuss care in private areas, not hallways or elevators.

Question 34

NYS Long-Term Care Ombudsman

Accepted Answer

Advocates for nursing home and adult care facility residents. Residents and families can contact the ombudsman program to report concerns about care, rights violations, or abuse without fear of facility retaliation.

Question 35

Advance directives

Accepted Answer

Legal documents expressing a resident's healthcare wishes: living will (treatment preferences) and healthcare proxy (designated decision-maker). CNAs must honor documented wishes and notify the nurse if a resident's condition changes.

Question 36

Therapeutic communication

Accepted Answer

Patient, empathetic listening focused on the resident's concerns. Use open-ended questions, reflect feelings, maintain eye contact at resident's level, and avoid minimizing ('Don't worry') or giving false reassurance.

Question 37

SBAR reporting

Accepted Answer

Structured handoff format: Situation (what is happening), Background (relevant history), Assessment (what you observed), Recommendation (what you need). Use when reporting changes to the nurse for clear, concise communication.

Question 38

Reporting resident changes

Accepted Answer

CNAs must report immediately — not at end of shift: changes in vital signs, skin condition, mental status, pain, intake/output, falls, or refusal of care. Timely reporting enables early intervention and is a legal duty.

Question 39

Dementia care approach

Accepted Answer

Use simple one-step directions, maintain consistent routines, approach from the front, identify yourself each time, and avoid arguing with delusions. Redirect to a calming activity rather than correcting false beliefs.

Question 40

Sundowning

Accepted Answer

Increased confusion, agitation, and restlessness in late afternoon/evening common in dementia. Increase lighting, reduce noise, maintain routine, and provide reassurance. Report patterns to the nurse for care plan adjustment.

Question 41

Depression in elderly residents

Accepted Answer

Signs: withdrawal, loss of appetite, sleep changes, expressions of hopelessness, decreased participation in activities. Report observations to the nurse — CNAs do not diagnose but are often first to notice behavioral changes.

Question 42

End-of-life care role

Accepted Answer

Provide comfort, dignity, and emotional support. Honor advance directives, keep resident clean and positioned for comfort, allow family presence, and report signs of pain or distress to the nurse for palliative interventions.

Question 43

Critical steps (clinical skills exam)

Accepted Answer

Each skill has mandatory critical steps defined by Prometric. Missing ANY critical step fails that skill regardless of other correct actions. Practice until critical steps are automatic — hand hygiene is critical on nearly every skill.

Question 44

NY clinical skills peer-pairing

Accepted Answer

New York uses a peer-pairing system where candidates perform skills on each other or a mannequin per Prometric instructions. Know all skills from the approved list — 5 are randomly selected on test day.

Question 45

Commonly tested clinical skills

Accepted Answer

Hand hygiene, vital signs, positioning, transfers, perineal care, partial bed bath, mouth care, ROM exercises, and dressing assistance. Hand hygiene is evaluated throughout all skills and is almost always included.

Question 46

Restraint policy

Accepted Answer

Physical restraints require a physician order and are a last resort. Alternatives first: repositioning, toileting schedule, activities, call light within reach. Never apply restraints without an order — unauthorized restraint is abuse.

Question 47

Abuse, neglect, and misappropriation

Accepted Answer

Abuse: intentional harm. Neglect: failure to provide necessary care. Misappropriation: taking resident property. All three are reportable offenses that can result in criminal charges and permanent registry disqualification in New York.

Question 48

Cultural and spiritual sensitivity

Accepted Answer

Respect dietary restrictions, prayer times, grooming preferences, and modesty needs across cultures. Ask residents about preferences rather than assuming. Accommodate within the care plan and facility capability.

Question 49

Weight-bearing transfer cue

Accepted Answer

When assisting a standing pivot transfer, instruct the resident to 'nose over toes' to shift weight forward onto the strong leg. Support at the waist or gait belt — never pull on the affected arm or shoulder.

Question 50

Confused resident attempting to leave

Accepted Answer

Do not physically restrain without an order. Notify the nurse immediately and stay with the resident to ensure safety. Elopement risk residents may have wander precautions or alarm devices per the care plan.

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