5.5 Integrated Practice & Final Readiness

Exam Logistics Cram (Minnesota / D&SDT-Headmaster)

The competency exam has two parts you must both pass to be placed on the Minnesota Nurse Aide Registry, maintained by the Minnesota Department of Health (MDH).

Knowledge blueprint (70 questions): Basic Nursing Skills 15, Infection Control 8, Safety 8, Care of the Impaired 6, Resident Rights 5, Role & Responsibility 5, Aging/Restorative 4, Communication 4, Data Collection 4, Disease Process 4, Personal Care 4, Mental Health 3.

Pacing: 60 minutes for 70 questions is about 51 seconds each — read fully, flag tough items, and answer everything since there is no guessing penalty.

Clinical Cram: Vitals & Measurement Tolerances

Normal adult vital signs:

Minnesota skills-test measurement tolerances (your number vs. the RN observer):

Conversions & rules: 1 ounce = 30 mL; measure output with the graduate at eye level on a flat surface; count pulse and respirations for a full minute; ROM is repeated at least 3 times per joint to slight resistance, never to pain. Report any vital outside the normal range to the nurse.

Safety, Infection Control & Resident Rights Cram

Infection control: Perform hand hygiene before and after every resident contact — soap and water for at least 20 seconds, or sanitizer until dry. Standard precautions treat all blood and body fluids as infectious. PPE order — don: gown, mask, goggles, gloves; doff: gloves, goggles, gown, mask (gloves first because they are dirtiest). Turn off the faucet with a clean paper towel.

Safety mnemonics: Fire — RACE (Rescue, Alarm, Confine, Extinguish) and extinguisher PASS (Pull, Aim, Squeeze, Sweep). For a falling resident, ease them to the floor protecting the head — never try to hold them fully upright.

Resident rights (OBRA) — high-yield list:

• Right to be free from abuse, neglect, and restraints
• Right to privacy and confidentiality
• Right to be treated with dignity and respect
• Right to make personal choices (clothing, schedule, activities)
• Right to voice grievances without fear
• Right to refuse care and to manage personal finances
• Right to confidential, private communication and visitors

Minnesota mandated reporting: Under the Vulnerable Adults Act, a CNA who suspects abuse, neglect, or financial exploitation must report immediately to the Minnesota Adult Abuse Reporting Center (MAARC) at 1-844-880-1574, staffed 24/7. You report a reasonable suspicion — you do not need proof, and you do not investigate or confront the suspected abuser yourself.

Abuse types to recognize: physical, verbal/emotional (threats, humiliation), sexual, financial exploitation, and neglect (failing to provide needed care). Restraints are a major rights issue: they are used only with a physician order, for the shortest time, with frequent checks and release for repositioning, toileting, and range of motion — and side rails can be a restraint. A resident may refuse care or treatment; honor it, explain the benefit calmly, and report the refusal to the nurse.

Test-Taking & Test-Day Plan

Reading the question: circle the keyword — first, best, most important, never, except. When two answers look right, pick the one that keeps the resident safe (airway, breathing, bleeding, falls first), respects their rights, and stays inside the CNA scope of practice. The medically dramatic choice is usually a trap; the correct answer is often report to the nurse.

Most common reasons candidates fail: rushing past the keyword; choosing an action outside scope (assessing, diagnosing, giving meds, taking orders); skipping hand hygiene, privacy, or the call light on a skill; leaving the bed up; and leaving knowledge questions blank.

Final week: take timed full-length practice tests above the 74% line (52 of 70 correct); re-drill Basic Nursing Skills, Infection Control, and Safety (the three biggest knowledge blocks); practice skills out loud with the begin/end routine; confirm your Headmaster/TMU appointment and report time.

Test day: arrive 20-30 minutes early to check in; bring valid government-issued, signed, unexpired photo ID; re-present ID when entering each room; eat and hydrate; read each item fully, flag tough ones, and answer every question. Stay calm — trust your training.

One-line reminders to carry in: report-don't-act when something is outside scope; safety and life threats first; clean-to-dirty in everything you touch; never document ahead; honor every resident right and report suspected abuse to MAARC. If you fail one part, you retest only that part (within your three attempts and 24-month window). Pass both, and the Minnesota Department of Health places you on the Nurse Aide Registry so you can work for pay.