Free Washington CNA Exam Flashcards

Washington's official credential is Nursing Assistant Certified (NAC). "Washington CNA" is a common search term, but state forms, the Board of Nursing, and Credentia all use NAC. Use NAC on every application.

Entry-level Washington designation requiring no formal training. NARs work only under nurse supervision with a narrower task range than a NAC and cannot independently perform the full certified scope.

An NAR employed in a Washington nursing home has four months to complete an approved training program and pass the competency exam to become certified. This lets staff begin working while training.

Standard applicants complete at least 108 hours of state-approved training: 35 classroom/theory, 33 skills lab, and 40 facility/clinical. This exceeds the 75-hour federal floor.

Washington Board of Nursing guidance: take and pass the in-person skills test BEFORE registering for the Credentia written/oral knowledge test. Testing out of order can delay certification.

Skills test is administered by the Washington training program (WABON regional scheduling when a program cannot provide it). Credentia administers only the online written or oral knowledge test.

70 multiple-choice questions with 10 unscored pretest items, two-hour limit. The oral option substitutes 60 multiple-choice plus 10 reading-comprehension or word-recognition items.

$100 skills test fee plus $55 written/oral knowledge fee = $155 total, before program tuition. Each retake requires a new fee. Nursing homes may be required to pay for covered employees.

State and federal rules allow four attempts to pass the written/oral exam. After four failures, the candidate must complete a state-approved training program and retake both parts.

The Nursing Care Quality Assurance Commission sets nursing-assistant standards, approves training programs, and can discipline, suspend, or revoke a NAC credential for misconduct. The DOH processes the applications.

Active certification requires providing paid nursing or nursing-related service at least once each two-year period. Washington does not currently mandate continuing-education hours for NAC renewal.

State registry recording training completion, test results, and any abuse/neglect/exploitation findings. Employers must check it before hiring to confirm status and screen for disqualifying findings.

An assistant certified elsewhere may apply for Washington certification by endorsement, with verification of good standing and training equivalent to Washington's 108-hour requirement.

Washington offers a shorter "bridge" pathway for current Home Care Aides (and a Medical Assistant bridge) that recognizes prior training so they can reach NAC certification faster.

Suspected abuse, neglect, or exploitation must be reported to the Department of Health and DSHS Adult Protective Services. Statewide hotline: 1-866-ENDHARM. Failure to report carries criminal penalties.

A Washington skills demonstration is scored on critical-element steps plus total steps. Missing a required critical element can fail the skill even if many other steps were performed correctly.

ADLs (bathing, dressing, grooming, eating, toileting, mobility) make up the largest knowledge domain on Washington's NNAAP-based written exam. Record each resident's assistance level so the care plan stays accurate.

Wash cleanest-to-dirtiest: face and neck first, working down, perineal area last. This sequence limits cross-contamination and lowers urinary tract infection risk. Keep the resident covered for warmth and dignity.

Dress the weak (affected) side first and undress it last. Positioning the weaker limb into the garment before the stronger side reduces pain and the risk of injury.

An aide may soak and clean a diabetic resident's feet but must NOT clip toenails or use a blade on calluses. Reduced circulation and sensation make minor cuts dangerous; a nurse or podiatrist does nail care.

Store dentures in a labeled container of cool water or denture solution. Hot water warps them, dry storage cracks the plastic, and a tissue risks accidental disposal.

Clean front to back (urethra toward anus) with a clean stroke each pass to prevent moving anal bacteria toward the urinary opening, reducing UTI risk.

Change a soiled brief immediately on discovery. Prolonged urine/stool contact macerates skin and can progress quickly to a pressure injury, a tracked quality measure in nursing facilities.

In every Washington facility, treat all residents' blood and body fluids as potentially infectious regardless of diagnosis: hand hygiene, appropriate PPE, safe handling of contaminated items, and respiratory etiquette.

Hand hygiene is the single most effective way to interrupt infection spread. Scrub with soap and water about 20 seconds, or use alcohol rub, before and after every resident contact and after removing gloves.

Added on top of standard precautions: Contact (gown/gloves, e.g., C. diff), Droplet (mask within close range, e.g., influenza), Airborne (N95, e.g., TB). Check door signage before entering.

Keep the far side rail up while working from the near side, change linens one side at a time, and never strip all linens off a resident who is still in the bed. Protects against falls and exposure.

Apply the gait belt over clothing at the waist, snug enough for only 1-2 fingers underneath, and grip from beneath. Never place it at the chest (restricts breathing) or use it after abdominal surgery.

Bath water should be roughly 105-115°F. Test on the inner wrist before contact, and adjust if the resident finds it too cold or hot within safe limits to protect fragile skin.

Document any unusual event (fall, injury, error) factually without blame, report to the nurse immediately, and keep the report out of the chart; it supports quality improvement, not punishment.

Wait at least 15-20 minutes after a resident eats, drinks, or smokes before an oral temperature. Hot or cold intake skews the reading high or low and produces a false value.

An aide records the reading and reports a clearly elevated value (e.g., 168/102) to the nurse immediately. Aides do not give medication; delaying the report can constitute negligence.

Count 30 seconds and double if regular, or a full 60 seconds if irregular or abnormal. Keep the resident unaware, because awareness changes the breathing pattern voluntarily.

Use the pads of the index and middle fingers over the radial artery. Never use the thumb, which has its own pulse that can be mistaken for the resident's rate.

Weigh at the same time of day, same scale, and similar clothing. Daily 2-4 lb fluctuation from food and fluid means inconsistent conditions hide real weight trends the nurse needs.

Repositioning an immobile resident at least every two hours relieves pressure on bony prominences (sacrum, heels, hips) so blood flow returns before tissue death starts a pressure injury.

Bend the knees not the waist, keep the back straight, hold the load close, and turn with the feet instead of twisting. Twisting under load sharply raises lumbar injury risk.

Semi-Fowler's is roughly 15-30°, standard Fowler's about 45-60°, and High Fowler's about 60-90°. High Fowler's aids residents with severe breathing difficulty.

Apply TED hose before the resident gets out of bed and stands. Standing lets blood pool and veins dilate, so stockings applied afterward are far less effective at preventing clots.

Place an unconscious resident on the side (lateral) with the head turned during mouth care. Supine lets fluids pool in the throat and be aspirated into the lungs.

Lock the wheelchair, position it on the resident's stronger side, apply the belt at the waist over clothing, and lift with leg muscles on a counted signal. Never lift by pulling under the arms.

Federal nursing-home protections enforced in Washington by the DOH: dignity, privacy, choice, grievance filing, freedom from abuse and unnecessary restraint, and participation in care planning.

A resident may refuse a meal or treatment. The aide removes the tray, documents exactly what was and was not taken, and reports the refusal to the nurse; pressuring the resident violates their rights.

Honor a resident's request for privacy during a bed bath by closing curtains/doors and letting them wash areas they can manage, while still ensuring safe, complete care.

Keep resident information confidential except where disclosure is legally required (mandatory abuse reporting) or needed to protect the resident or others from harm. Casual disclosure breaches HIPAA.

Washington law requires immediate reporting through proper channels. Waiting for more proof or staying silent violates mandatory-reporter duty; stopping immediate harm is appropriate, but the report is still required.

Report promptly: vital-sign changes, new pain, skin breakdown, falls, behavior shifts, abnormal output, and care refusals. A clear, factual handoff lets the nurse assess and act.

Seat the resident upright (around 90°), give small bites, allow time to chew and swallow, and watch for coughing or a wet voice that signals dysphagia and aspiration risk.

Use a calm environment, simple steps, consistent routine, and gentle redirection rather than arguing about reality. Acknowledge feelings to reduce agitation and keep the resident safe.

An aide performs delegated tasks under nurse supervision and may not give medications, do sterile procedures, take verbal orders, diagnose, or perform the initial assessment. When unsure, ask the nurse.