Washington CNA Exam Flashcards

Q: What is the official name of the Washington CNA credential?

Washington uses 'Nursing Assistant Certified' (NAC). Most candidates search 'Washington CNA,' but state paperwork, the Washington Board of Nursing, the Department of Health credentialing office, and the Credentia knowledge exam all use the NAC term. Enter your correct NAC credential number in Credentia to avoid processing delays.

Q: How many training hours does Washington require for NAC?

Washington requires a minimum of 108 hours through a state-approved program for standard applicants: 35 hours classroom/theory, 33 hours skills lab, and 40 hours facility/clinical. This exceeds the federal minimum of 75 hours and is overseen by the Nursing Care Quality Assurance Commission (NCQAC).

Q: Do I take the Washington skills test or written test first?

Skills first. Current Washington Board of Nursing guidance says candidates should pass the in-person skills test before registering for the Credentia written or oral knowledge test. Testing out of order can delay certification, and both parts must be passed for certification consideration.

Q: What is the difference between NAR and NAC in Washington?

NAR (Nursing Assistant Registered) requires no formal training and works under nurse supervision with a limited task range. NAC (Nursing Assistant Certified) requires meeting training or eligibility requirements and passing both exam parts. An NAR employed in a nursing home has four months to complete approved training and testing.

Q: How much does the Washington NAC exam cost?

Current Washington guidance lists a $100 skills test fee and a $55 written or oral knowledge test fee, for a $155 exam total before training-program tuition or other credentialing costs. A new fee is required for each retake. Nursing homes may be required to cover exam costs for covered employees.

Q: How many times can I retake the Washington written exam?

State and federal regulations allow four attempts to pass the written or oral examination. After four failures, the candidate must complete a state-approved training program and retake both parts. Skills retake details should be confirmed with the training program or WABON regional skills process.

Question 1

NAC vs. "Washington CNA"

Accepted Answer

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.

Question 2

NAR (Nursing Assistant Registered)

Accepted Answer

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.

Question 3

NAR-to-NAC four-month rule

Accepted Answer

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.

Question 4

Washington NAC training-hour minimum

Accepted Answer

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.

Question 5

Skills test first (Washington order)

Accepted Answer

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.

Question 6

Who runs each Washington exam part

Accepted Answer

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.

Question 7

Washington written exam structure

Accepted Answer

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.

Question 8

Washington exam fees

Accepted Answer

$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.

Question 9

Washington written-exam attempt limit

Accepted Answer

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.

Question 10

NCQAC role in Washington

Accepted Answer

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.

Question 11

Washington NAC continuing competency

Accepted Answer

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.

Question 12

Washington Nurse Aide Registry

Accepted Answer

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.

Question 13

Out-of-state NAC endorsement

Accepted Answer

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.

Question 14

HCA bridge to NAC

Accepted Answer

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.

Question 15

Washington mandatory reporting target

Accepted Answer

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.

Question 16

Skills-test passing logic

Accepted Answer

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.

Question 17

ADLs on the Washington knowledge outline

Accepted Answer

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.

Question 18

Complete bed bath order

Accepted Answer

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.

Question 19

Dressing a resident with one-sided weakness

Accepted Answer

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.

Question 20

Diabetic foot and nail care limit

Accepted Answer

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.

Question 21

Denture storage

Accepted Answer

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.

Question 22

Perineal care direction (female)

Accepted Answer

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.

Question 23

Incontinence brief response

Accepted Answer

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.

Question 24

Standard Precautions in WA long-term care

Accepted Answer

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.

Question 25

Hand hygiene as primary control

Accepted Answer

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.

Question 26

Transmission-based precautions

Accepted Answer

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.

Question 27

Occupied-bed safety

Accepted Answer

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.

Question 28

Gait belt application

Accepted Answer

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.

Question 29

Bath water temperature check

Accepted Answer

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.

Question 30

Incident reporting

Accepted Answer

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.

Question 31

Oral temperature timing

Accepted Answer

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.

Question 32

Reporting an abnormal blood pressure

Accepted Answer

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.

Question 33

Counting respirations

Accepted Answer

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.

Question 34

Radial pulse technique

Accepted Answer

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.

Question 35

Consistent weighing conditions

Accepted Answer

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.

Question 36

Two-hour repositioning purpose

Accepted Answer

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.

Question 37

Body mechanics for lifting

Accepted Answer

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.

Question 38

Fowler's position angles

Accepted Answer

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.

Question 39

Anti-embolism stocking timing

Accepted Answer

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.

Question 40

Unconscious oral-care position

Accepted Answer

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.

Question 41

Transfer to wheelchair with gait belt

Accepted Answer

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.

Question 42

Resident rights under OBRA

Accepted Answer

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.

Question 43

Right to refuse food or care

Accepted Answer

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.

Question 44

Privacy during personal care

Accepted Answer

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.

Question 45

Confidentiality exceptions

Accepted Answer

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.

Question 46

Witnessing staff abuse

Accepted Answer

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.

Question 47

Reporting changes to the nurse

Accepted Answer

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.

Question 48

Aspiration prevention at meals

Accepted Answer

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.

Question 49

Dementia communication approach

Accepted Answer

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.

Question 50

Nurse-aide scope of practice

Accepted Answer

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.

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