Free New York CNA Exam Flashcards

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.