NURSING ASSISTANT/ NURSE AIDE EXAM

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NURSING ASSISTANT/ NURSE AIDE EXAM NURSING ASSISTANT/ NURSE AIDE EXAMNURSING ASSISTANT/ NURSE AIDE EXAM N E W Y O R K 2nd EditionCopyright © 2002 LearningExpress, LLC. All rights reserved u ... nder International and Pan-American Copyright Conventions. Published in the United States by LearningExpress, LLC, New York. Library of Congress Cataloging-in-Publication Data: Nursing assistant / nurse aide exam.—2nd ed. p. cm. 1. Nurses’ aides—Examinations—Study guides. I. LearningExpress (Organization) RT84 .N864 2002 610.73'06'98—dc21 2002003582 Printed in the United States of America 9 8 7 6 5 4 3 2 1 Second Edition ISBN 1-57685-418-3 For more information or to place an order, contact LearningExpress at: 900 Broadway Suite 604 New York, NY 10003 Or visit us at: www.learnatest.comMarlene Beck, RN, MSN is a Nursing Instructor at the Bridgeport Hospital School of Nursing. She has had extensive experience as a manager and an educator. In her current position at the school of nursing, she has been instrumental in curriculum development, teaching, and clinical supervision. Previously, she was Administrative Manager of Organization, Development, and Education at Bridgeport Hospital/Yale New Haven Healthcare System. In this role, she developed and implemented the first Certified Nursing Assistant Program for the hospital. She lives in Seymour, Connecticut. Patricia Mulrane is a freelance writer with a Bachelor of Arts in Print Media. She began her publishing career in 1994 and is currently Marketing Director for Peter Lang Publishing/USA, a scholarly press in New York City. She lives in Brooklyn, New York. Caren Silhavey, RN, MSN, CURN is a Nursing Instructor at the Bridgeport Hospital School of Nursing, Bridgeport, Connecticut. Prior to that, she was a Staff Development Instructor in the Organizational Development and Education Department at Bridgeport Hospital, where she taught and was the Coordinator of the Clinical Care Provider Program (extended Nursing Assistant) and the Certified Nursing Assistant Program. She lives in Stratford, Connecticut. National Occupational Competency Testing Institute (NOCTI) is a recognized leader in occupational competency testing and has developed and validated more than 250 written exams and performance assessments that measure the skills of entry-level and experienced workers. A nonprofit institute, NOCTI has created hundreds of customized workplace-related assessments for such major corporations as Disney, Toyota, GTE, and 3M. List of Contributors vCHAPTER 1: The Nursing Assistant/Nurse Aide Exam 1 CHAPTER 2: The LearningExpress Test Preparation System 9 CHAPTER 3: Nursing Assistant/Nurse Aide Practice Exam 1 25 CHAPTER 4: Nursing Assistant/Nurse Aide Practice Exam 2 41 CHAPTER 5: Nursing Assistant/Nurse Aide Practice Exam 3 55 CHAPTER 6: Nursing Assistant/Nurse Aide Practice Exam 4 71 CHAPTER 7: Nursing Assistant/Nurse Aide Practice Exam 5 85 CHAPTER 8: Nursing Assistant/Nurse Aide Practical Skills Exam 99 CHAPTER 9: Certification Requirements and Trends 105 CHAPTER 10: Important Resources 111 APPENDIX: Nursing Assistant/Nurse Aide Practice Exam Question Outline 125 Contents viiNURSING ASSISTANT/ NURSE AIDE EXAMIN T H I S DAY require not only formal training, but also some type of recognized certification. This is particularly true for many healthcare professions, including nursing assistant/nurse aide (NA). and age of professionalism, many careers that years ago didn’t require much expertise now Prior to 1987, there were no standards in nursing homes and the quality of care was in question. As the public began to hear horrible stories in the media of the abuse and mistreatment of residents in nursing homes, the government decided to step in and take action. The result was the Omnibus Budget and Reform Act (OBRA), which required the implementation of standards for nursing homes that receive federal funds such as Medicare or Medicaid. The act also emphasized residents’ rights, Registered Nurse (RN) presence, and improved food and medical services for patients, along with better maintenance and housekeeping. Due to these new standards, states now individually regulate the training and testing of Certified Nursing Assistants (CNAs). The information in this book is based on the national standards for CNAs, but each state specifies the amount of training, and what certification and practical skills exams CNAs must pass. Therefore, you will also need to contact state or local agencies to find out about the specific requirements in your state. C H A P T E R The Nursing Assistant/Nurse Aide Exam CHAPTER SUMMARY This chapter introduces you to the certification process for nursing assistants and shows you how to use this book to help you prepare for the exam to become a Certified Nursing Assistant (CNA). 1 1 Finding Out about Certification Requirements If you want to become a CNA, the first step is to contact your local community or state health agency to obtain certification requirements. You can find these agencies listed in the blue (government) pages of your phone book. You can also contact an employment agency or the healthcare facility you want to work for, since they will often be able to guide you through the training and certification requirements. To give you an idea of what to expect, see Chapter 9 for an outline of some of the current trends in CNA certification. OBRA laws also require that a state registry be kept for CNAs. Information such as dates of certification, reports of abuse and neglect, and lapse periods are available in these registries. Turn to page 4 for a list of registries by state. Education and Training Healthcare facilities usually require CNAs to have a high school diploma or GED and to pass a stateapproved training program that consists of anywhere from 75 to 150 hours of training. You can be hired without being certified, but you must receive certification within four months after your hire date. While the duties of a nursing assistant vary depending on the workplace, the job emphasis is always on the physical and emotional well-being of the patient. While a day in the life of a CNA is not easy, especially when dealing with a difficult patient, most CNAs get great satisfaction from their work. Common characteristics for someone considering this profession are dedication, patience, reliability, and compassion. Another key element to the job is the ability to communicate and work well with others. A CNA must also be physically able to perform the job—such as standing for a good portion of an eight-hour day and lifting and moving objects and equipment. As a CNA, your training will consist of learning to perform the following basic duties: ■ communicating with the patient and others on the job ■ bathing and dressing the patient (general skin care and hygiene) ■ helping patients out of bed ■ setting up and storing medical equipment ■ taking vital signs—pulse, blood pressure, temperature, and respiration ■ feeding the patient ■ changing bed linens ■ cleaning bedpans and measuring urine output ■ answering patients’ calls and delivering messages Career Outlook and Earning Potential The nursing assistant profession, on the whole, is growing faster than average. Nurse aides held about 1.4 million jobs in 1998, and that number is expected to increase by almost 25% by 2008. While job prospects are good, the salaries tend to be low. Hourly wages range from about $6.00 to $12.00, depending on which part of the country you live in. Salaries in the Northeast are highest, while the South is lower paying. If you have five years of experience or more, your pay increases by a few dollars per hour. Paid holidays, hospital and medical benefits, extra pay for overtime, and pension plans are available to many hospital and some nursing home employees. Once you know what you have to do to be certified in your state, you can begin to plan your CNA study program. Go to a local job counseling center, state employment agency, or private healthcare job placement service to get information about how to get the training you need to become a CNA. Many healthcare agencies will provide you with the training you need. Or you may be able to prepare on your own and –THE NURSING ASSISTANT/NURSE AIDE EXAM– 2simply go in to demonstrate your competence by taking a written exam, demonstrating your skills in a practical exam, or both. Whether you are involved in a training class or working on your own, you should be using textbooks and other materials that will train you in the most important skills a CNA needs. Such books will be available in public libraries and college bookstores; job search agencies may also have some supplemental materials available. How to Use This Book Many state and local agencies require a written exam consisting of approximately 70 multiple-choice questions as part of the certification process for CNAs. This book contains five practice written exams, based on the national standards, that contain questions about all the skills you will use as a CNA. The written portion of the nursing assistant exam consists of multiple-choice questions, while the clinical portion has the test taker performing five on-the-job skills. Some of the skills tested include: ■ Personal Care Skills—such as client bathing, grooming, dressing, toileting, skin care, nutrition, and more ■ Basic Nursing Skills—such as providing a safe and/or clean environment, recognizing abnormal signs or symptoms of diseases and conditions, communicating with clients, understanding basic principles of infection and control, and more ■ Mental Health and Social Service Needs—such as psychosocial characteristics of populations, identification of developmental tasks associated with aging, behavior management, and so on ■ Basic Restorative Devices—use of assistive devices, range of motion, client transfer, bowel and bladder training, and care and use of prosthetic devices ■ Client’s Rights—such as privacy, grievances, client and family group participation, physical and chemical restraints, personal possessions, and more ■ Employability Skills—such as acquiring a job and maintaining a job Even if your state or agency doesn’t require a written exam, you will find that these practice exams are a valuable way to review and solidify your skills. Once you have completed your course of study, you are ready to take the first practice exam in this book. Each practice exam contains 70 multiple-choice questions on all aspects of the job. Allow yourself enough time to complete the entire exam at one sitting, approximately two-and-a-half hours. Each practice exam has an answer key at the end, which not only tells you the right answer, but also explains why that answer is right. In general, you should count yourself successful when you can score at least 75%. If you don’t get that score on the first practice exam, don’t panic! First, review the answer explanations to see where you went wrong. Then, see which areas you did well in and which areas gave you more trouble. Go back to your textbook or other training materials to review your weakest areas. Then take the second practice exam. You should find that your score improves. Continue this process—reviewing, taking a practice exam, more review—until you have completed all five practice exams in this book. That way you will be well prepared for any state certification exam you may have to take. Practice with the exams in this book is not a guarantee that you will pass a state certification exam—or get a job as a CNA. But it certainly does bring you closer to those goals than if you had not studied and prepared! In addition to the practice written exams, this book also includes a sample performance assessment in Chapter 8. This is a sample of the kind of job tasks you will perform as a CNA. You may be asked to per- –THE NURSING ASSISTANT/NURSE AIDE EXAM– 3form tasks like these either during a state certification exam or by a prospective employer during a job interview. You should practice these tasks and become proficient enough to perform them under pressure with an examiner or your potential employer watching you closely. Carefully practicing these skills will help you sell yourself to your employer and will put you ahead of other people applying for the same position. Keep in mind that the best-trained person is usually the one who is selected for the position. Here are the steps to take to become a CNA: 1. Contact local employment agencies or the state health office to find out about certification standards. (A list of state registries follows.) 2. Contact local employment agencies for employment opportunities. 3. Take your CNA course and/or use study guides and textbooks to prepare for certification. 4. Take the first practice exam in this book and score it. Review your weakest areas. 5. Continue to review and take practice exams. Score yourself on each exam to see how prepared you are for the actual certification exam. 6. Once you feel confident, contact your state or local agency to set a date for taking the certification exam. 7. Take the certification exam and pass it! 8. Show prospective employers your certificate. This shows you are ready to start a job and have the initiative to advance once you are hired. If you faithfully follow these steps, you will be well on your way to a successful career as a certified nursing assistant. Nursing Assistant State Registries ALABAMA Department of Public Health Division of License and Certification 434 Monroe Street Moffitt Building Montgomery, AL 36130-3017 334-261-6505 ALASKA Division of Occupational Licensing Alaska State Board of Nursing 3601 C Street, #722 Anchorage, AK 99503 907-561-2878 ARIZONA Arizona State Board of Nursing 1651 East Morten, Suite 150 Phoenix, AZ 85020 520-255-5455 ARKANSAS Department of Human Services Division of Medical Services Mail Slot 405, P.O. Box 8059 Little Rock, AR 72203-8059 501-682-8484 CALIFORNIA Department of Health Services Division of Licensing and Certification P.O. Box 942732 Sacramento, CA 94234-7320 916-327-2445 COLORADO Department of Regulatory Agencies State Board of Nursing 1560 Broadway, #670 Denver, CO 80202 303-894-2816 CONNECTICUT Assessment Systems, Inc. Processing Center Suite 300 3 Bala Plaza West Bala Cynwyd, PA 19004-3481 800-274-2900 –THE NURSING ASSISTANT/NURSE AIDE EXAM– 4DELAWARE Division of Public Health Health Facilities Licensing and Certification 3 Mill Road, Suite 308 Wilmington, DE 19800 302-577-6666 DISTRICT OF COLUMBIA Department of Consumer and Regulatory Affairs 614 H Street NW, #1003 Washington, DC 20001 202-727-7190 FLORIDA Agency for Health Care Administration 2727 Mahen Drive Tallahassee, FL 32308 904-488-8401 GEORGIA Georgia Nurse Aide Registry Georgia Department of Human Resources 2 Peachtree Street, NW, 21st Floor Atlanta, GA 30303-3167 404-657-5730 HAWAII Nurse Assistant Competency Testing American Red Cross, Hawaii Chapter 4155 Diamond Head Road Honolulu, HI 96816-4417 808-734-2101 Fax: 808-734-8318 IDAHO Idaho Board of Nursing P.O. Box 83720 Boise, ID 83720-0061 208-334-3110 ILLINOIS Department of Public Health Education 525 West Jefferson Springfield, IL 62761 217-782-3070 INDIANA State Board of Health 1330 West Michigan P.O. Box 1964 Indianapolis, IN 46206-1964 317-383-6612 or 317-633-0639 IOWA Department of Inspections and Appeals Health Facilities Division Lucas State Office Building Des Moines, IA 50319-0083 515-281-4963 KANSAS Department of Health and Environment Health Occupation Credential Unit 109 SW 9th Street, Suite 400B Topeka, KS 66612-2218 913-296-6877 KENTUCKY Cabinet for Human Resources Division of Licensing and Regulation 274 East Main Street CHR Building, 4th Floor East Frankfort, KY 40621 502-564-2800 LOUISIANA Board of Examiners for Nursing Home Administrators 5615 Corporate Boulevard, Suite 8D Baton Rouge, LA 70808 504-925-4591 MAINE Department of Human Resources—CNA Registry State House Station 11 35 Anthony Avenue Augusta, ME 04333 207-287-3707 MARYLAND Maryland CNA Registry Psychological Corporation P.O. Box 839963 San Antonio, TX 78283-9963 800-622-3231 MASSACHUSETTS Department of Public Health Division of Health Care Quality 10 West Street Boston, MA 02111 617-727-5860 MICHIGAN Health Management Associates 120 North Washington Square, #905 Lansing, MI 48933 517-371-9091 or 800-748-0252 –THE NURSING ASSISTANT/NURSE AIDE EXAM– 5MINNESOTA Minnesota Department of Health Facility and Provider Compliance Division Nurse Assistant Registry 393 North Dunlap Street P.O. Box 64501 St. Paul, MN 55164-0501 612-643-2176 or 800-397-6124 MISSISSIPPI Mississippi Board of Nursing 239 North Lamar, #401 Jackson, MS 39201 601-359-6182 MISSOURI Health Education Unit Division of Aging P.O. Box 1337 Jefferson City, MO 65102 314-571-3082 or 314-526-5686 (voice mail) MONTANA Department of Health Licensing and Certification Bureau Cogswell Building, Room C-211 Helena, MT 59620 406-444-2037 NEBRASKA Department of Health Bureau of Health Facility Standards 301 Centennial Mall South P.O. Box 95007 Lincoln, NE 68509-5007 402-471-0537 NEVADA State Board of Nursing 1755 East Plumb Lane, Suite 260 Reno, NV 89502 702-786-2778 or 702-739-0129 NEW MEXICO Department of Health Licensing and Certification P.O. Box 26110 Santa Fe, NM 87501 505-827-4206 Fax: 505-827-4203 NEW HAMPSHIRE New Hampshire Board of Nursing Division of Public Health Services 6 Hazen Drive Concord, NH 03301 603-271-6282 or 603-271-6599 NEW JERSEY Assessment Systems, Inc. Processing Center, Suite 300 3 Bala Plaza West Bala Cynwyd, PA 19004-3481 800-274-2900 NORTH CAROLINA Department of Health and Human Services Division of Facility Services Nurse Aide Training and Registry Administration 2709 Mail Service Center Raleigh, NC 27699-2709 919-733-2786 Voice Response System: 919-715-0562 www.ncnar.org NORTH DAKOTA North Dakota Department of Health Division of Emergency Health Services 600 E Blvd Avenue, Department 301 Bismarck, ND 58505-0200 701-328-2388 Fax: 701-328-1890 E-mail: [email protected] OHIO Department of Health Nurse Aide Unit P.O. Box 118 Columbus, OH 43266-0118 800-582-5908 or 614-752-9500 OKLAHOMA Oklahoma State Department of Health 1000 NE 10th Street Oklahoma City, OK 73117-1299 800-695-2157 OREGON Board of Nursing, Program Executive 800 Northeast Oregon Street, Suite 465 Portland, OR 97232 503-731-4745 –THE NURSING ASSISTANT/NURSE AIDE EXAM– 6PENNSYLVANIA Department of Health Division of Long Term Care P.O. Box 90, Room #526 Harrisburg, PA 17108 717-787-1816 RHODE ISLAND Department of Health Division of Professional Regulation 3 Capitol Hill, Room 104 Providence, RI 02098 401-277-2827 SOUTH CAROLINA Department of Health and Environment 2600 Bull Street Columbia, SC 29201 803-737-7207 SOUTH DAKOTA Board of Nursing 3307 S. Lincoln Avenue Sioux Falls, SD 57105 605-367-5940 Fax: 605-367-5945 TENNESSEE Department of Health 283 Plus Park Boulevard Nashville, TN 37247-0530 615-367-6344 TEXAS Department of Human Services Nurse Aide Registry P.O. Box 149030, Mail Code Y-977 Austin, TX 78714-9030 512-834-6670 UTAH Nurse Aide Registry 550 East 300 South Kaysville, UT 84037 801-547-9947 VERMONT Vermont Board of Nursing 109 State Street Secretary of State Office Montpelier, VT 05609-1106 802-828-2819 VIRGINIA Department of Health Professionals Board of Nursing 6606 West Broad Street, 4th Floor Richmond, VA 23230-1717 804-662-7310 WASHINGTON Department of Social and Health Services OBRA Nursing Assistant Registry P.O. Box 45600 Olympia, WA 98504-5600 360-438-7925 WEST VIRGINIA Health Facility Licensure and Certification 1900 Kanawha Boulevard East, Building #3 Charleston, WV 25305 304-558-0050 WISCONSIN Department of Health and Social Services Bureau of Quality Compliance 1 West Wilson Street P.O. Box 2569 Madison, WI 53701 608-267-2374 WYOMING State Board of Nursing 2020 Carey Street, Suite 110 Cheyenne, WY 82002 307-777-7601 –THE NURSING ASSISTANT/NURSE AIDE EXAM– 7FI R S T it. Your future career as a nursing assistant depends on passing the test, but there are all sorts of pit- falls that can keep you from doing your best on this all-important exam. Here are some of the obsta- , T H E B A D news: Taking the nursing assistant exam is no picnic, and neither is getting ready for cles that can stand in the way of your success: ■ Being unfamiliar with the format of the exam ■ Being paralyzed by test anxiety ■ Leaving your preparation to the last minute ■ Not preparing at all! ■ Not knowing vital test-taking skills: how to pace yourself through the exam, how to use the process of elimination, and when to guess ■ Not being in tip-top mental and physical shape ■ Messing up on test day by arriving late at the test site, having to work on an empty stomach, or shivering through the exam because the room is cold C H A P T E R The LearningExpress Test Preparation System CHAPTER SUMMARY Taking a nursing assistant certification exam can be tough, and your career in healthcare depends on your passing the exam. The LearningExpress Test Preparation System, developed exclusively for LearningExpress by leading test experts, gives you the discipline and attitude you need to succeed. 2 9What’s the common denominator in all these test-taking pitfalls? One word: control. Who’s in control, you or the exam? Now the good news: The LearningExpress Test Preparation System puts you in control. In just nine easy-to-follow steps, you will learn everything you need to know to make sure that you are in charge of your preparation and your performance on the exam. Other test-takers may let the test get the better of them; other test-takers may be unprepared or out of shape— but not you. You will have taken all the steps you need to take to get a high score on the nursing assistant exam. Here’s how the LearningExpress Test Preparation System works: Nine easy steps lead you through everything you need to know and do to get ready to master your exam. Each of the steps listed below includes both reading about the step and one or more activities. It is important that you do the activities along with the reading, or you won’t be getting the full benefit of the system. Step 1. Get Information Step 2. Conquer Test Anxiety Step 3. Make a Plan Step 4. Learn to Manage Your Time Step 5. Learn to Use the Process of Elimination Step 6. Know When to Guess Step 7. Reach Your Peak Performance Zone Step 8. Get Your Act Together Step 9. Do It! If you have several hours, you can work through the whole LearningExpress Test Preparation System in one sitting. Otherwise, you can break it up and do just one or two steps a day for the next several days. It is up to you—remember, you are in control. Step 1: Get Information Activities: Read Chapter 1, “The Nursing Assistant Exam,” and use the suggestions there to find out about your certification requirements. Knowledge is power. Therefore, first, you have to find out everything you can about the nursing assistant exam. Once you have your information, the next steps will show you what to do about it. Part A: Straight Talk about the Nursing Assistant Exam Why do you have to take this exam, anyway? Because an increasing number of people, particularly elderly people, need to be cared for. And, since more and more people need these services, there is growing concern about the quality of care the patients get. One way to try to ensure quality of care is to test the people who give that care to find out if they have been well trained. And that’s why your state or the agency you want to work for may require you to take a written exam. It is important for you to remember that your score on the written exam does not determine how smart you are or even whether you will make a good nursing assistant. There are all kinds of things a written exam like this can’t test: whether you are likely to show up late or call in sick a lot, whether you can be patient with a trying client, or whether you can be trusted with confidential information about people’s health. Those kinds of things are hard to evaluate on a written exam. Meanwhile, it is easy to evaluate whether you can correctly answer questions about the job duties of a nursing assistant/nurse aide. This is not to say that correctly answering the questions on the written exam is not important! The knowledge tested on the exam is knowledge you will need to do your job, and your ability to enter the profession you have trained for depends on your passing this exam. And that’s why you are here—to achieve control over the exam. –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 10Part B: What’s on the Test If you haven’t already done so, stop here and read Chapter 1 of this book, which gives you an overview of the written exam. Chapter 1 also suggests ways to find out about certification requirements in your state. At this point, you may also want to skip ahead to Chapter 9 to uncover some of the trends in healthcare licensing requirements. Later, you will have the opportunity to take the sample practice exams in Chapters 3 through 7. Chapter 8 will help you go through the clinical skills area of the test. Step 2: Conquer Test Anxiety Activity: Take the Test Anxiety Quiz on page 12. Having complete information about the exam is the first step in getting control of the exam. Next, you have to overcome one of the biggest obstacles to test success: test anxiety. Test anxiety cannot only impair your performance on the exam itself; it can even keep you from preparing! In this step you will learn stress management techniques that will help you succeed on your exam. Learn these strategies now, and practice them as you complete the exams in this book so that they will be second nature to you by exam day. Combating Test Anxiety The first thing you need to know is that a little test anxiety is a good thing. Everyone gets nervous before a big exam—and if that nervousness motivates you to prepare thoroughly, so much the better. Many well-known people throughout history have experienced anxiety or nervousness—from performers such as actor Sir Laurence Olivier and singer Aretha Franklin to writers such as Charlotte Brontë and Alfred Lord Tennyson. In fact, anxiety probably gave them a little extra edge— just the kind of edge you need to do well, whether on a stage or in an examination room. Stop here and complete the Test Anxiety Quiz on the next page to find out whether your level of test anxiety is something you should worry about. Stress Management Before the Test If you feel your level of anxiety getting the best of you in the weeks before the test, here is what you need to do to bring the level down again: ■ Get prepared. There’s nothing like knowing what to expect and being prepared for it to put you in control of test anxiety. That’s why you are reading this book. Use it faithfully, and remind yourself that you are better prepared than most of the people taking the test. ■ Practice self-confidence. A positive attitude is a great way to combat test anxiety. This is no time to be humble or shy. Stand in front of the mirror and say to your reflection, “I’m prepared. I’m full of self-confidence. I’m going to ace this test. I know I can do it.” If you hear it often enough, you will come to believe it. ■ Fight negative messages. Every time someone starts telling you how hard the exam is or how it is almost impossible to get a high score, start telling them your self-confidence messages above. If the someone with the negative messages is you, telling yourself you don’t do well on exams or you just can’t do this, don’t listen. ■ Visualize. Imagine yourself reporting for duty on your first day as a certified nursing assistant. Think of yourself helping patients and making them more comfortable. Imagine coming home with your first paycheck. Visualizing success can help make it happen—and it reminds you of why you are working so hard to pass the exam. ■ Exercise. Physical activity helps calm down your body and focus your mind. Besides, being in good physical shape can actually help you do well on the exam. Go for a run, lift weights, go swimming—and do it regularly. Stress Management on Test Day There are several ways you can bring down your level of test anxiety on test day. They will work best if you –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 11Test Anxiety Quiz You only need to worry about test anxiety if it is extreme enough to impair your performance. The following questionnaire will provide a diagnosis of your level of test anxiety. In the blank before each statement, write the number that most accurately describes your experience. 0 = Never 1 = Once or twice 2 = Sometimes 3 = Often I have gotten so nervous before an exam that I simply put down the books and didn’t study for it. I have experienced disabling physical symptoms such as vomiting and severe headaches because I was nervous about an exam. I have simply not showed up for an exam because I was scared to take it. I have experienced dizziness and disorientation while taking an exam. I have had trouble filling in the little circles because my hands were shaking too hard. I have failed an exam because I was too nervous to complete it. Total: Add up the numbers in the blanks above. Your Test Anxiety Score Here are the steps you should take, depending on your score. If you scored: ■ Below 3, your level of test anxiety is nothing to worry about; it is probably just enough to give you that little extra edge. ■ Between 3 and 6, your test anxiety may be enough to impair your performance, and you should practice the stress management techniques listed in this section to try to bring your test anxiety down to manageable levels. ■ Above 6, your level of test anxiety is a serious concern. In addition to practicing the stress management techniques listed in this section, you may want to seek additional, personal help. Call your local high school or community college and ask for the academic counselor. Tell the counselor that you have a level of test anxiety that sometimes keeps you from being able to take an exam. The counselor may be willing to help you or may suggest someone else you should talk to. 12practice them in the weeks before the test, so you know which ones work best for you. ■ Deep breathing. Take a deep breath while you count to five. Hold it for a count of one, then let it out for a count of five. Repeat several times. ■ Move your body. Try rolling your head in a circle. Rotate your shoulders. Shake your hands from the wrist. Many people find these movements very relaxing. ■ Visualize again. Think of the place where you are most relaxed: lying on the beach in the sun, walking through the park, or whatever makes you feel good. Now close your eyes and imagine you are actually there. If you practice in advance, you will find that you only need a few seconds of this exercise to experience a significant increase in your sense of well-being. When anxiety threatens to overwhelm you right there during the exam, there are still things you can do to manage the stress level. ■ Repeat your self-confidence messages. You should have them memorized by now. Say them quietly to yourself, and believe them! ■ Visualize one more time. This time, visualize yourself moving smoothly and quickly through the test answering every question correctly and finishing just before time is up. Like most visualization techniques, this one works best if you have practiced it ahead of time. ■ Find an easy question. Skim over the test until you find an easy question, and answer it. Getting even one circle filled in gets you into the testtaking groove. ■ Take a mental break. Everyone loses concentration once in a while during a long test. It is normal, so you shouldn’t worry about it. Instead, accept what has happened. Say to yourself, “Hey, I lost it there for a minute. My brain is taking a break.” Put down your pencil, close your eyes, and do some deep breathing for a few seconds. Then you will be ready to go back to work. Try these techniques ahead of time, and see if they don’t work for you! Step 3: Make a Plan Activity: Construct a study plan. Maybe the most important thing you can do to get control of yourself and your exam is to make a study plan. Too many people fail to prepare simply because they fail to plan. Spending hours poring over sample test questions the day before the exam not only raises your level of test anxiety, but it also will not replace careful preparation and practice over time. Don’t fall into the cram trap. Take control of your preparation time by mapping out a study schedule. On the following pages are two sample schedules, based on the amount of time you have before you take the written exam. If you are the kind of person who needs deadlines and assignments to motivate you for a project, here they are. If you are the kind of person who doesn’t like to follow other people’s plans, you can use the suggested schedules here to construct your own. Even more important than making a plan is making a commitment. You can’t review everything you learned in your nursing assistant course in one night. You need to set aside some time every day for study and practice. Try for at least 20 minutes a day. Twenty minutes daily will do you much more good than two hours on Saturday—divide your test preparation into smaller pieces of the larger work. In addition, making study notes, creating visual aids, and memorizing can be quite useful as you prepare. Each time you begin to study, quickly review your last lesson. This act will help you retain all you have learned and help you assess if you are studying effectively. You may realize you are not remembering some of the –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 13material you studied earlier. Approximately one week before your exam try to determine the areas that are still most difficult for you. Don’t put off your study until the day before the exam. Start now. A few minutes a day, with half an hour or more on weekends, can make a big difference in your score. Learning Styles Each of us absorbs information differently. Whichever way works best for you is called your dominant learning method. If someone asks you to help them construct a bookcase they just bought, that may be in many pieces, how do you begin? Do you need to read the directions and see the diagram? Would you rather hear someone read the directions to you—telling you which part connects to another? Or do you draw your own diagram? The three main learning methods are visual, auditory, and kinesthetic. Determining which type of learner you are will help you create tools for studying. Visual Learners need to see the information in the form of maps, pictures, text, words, or math examples. Outlining notes and important points in colorful highlighters and taking note of diagrams and pictures may be key in helping you study. Auditory Learners retain information when they can hear directions, the spelling of a word, a math theorem, or poem. Repeating information aloud or listening to your notes on a tape recorder may help. Many auditory learners also find working in study groups or having someone quiz them is beneficial. Kinesthetic Learners must do! They need to draw diagrams, write directions, etc. Rewriting notes on index cards or making margin notes in your textbooks also helps kinesthetic learners to retain information. Mnemonics Mnemonics are memory tricks that help you remember what you need to know. The three basic principles in the use of mnemonics are imagination, association, and location. Acronyms (words created from the first letters in a series of words) are common mnemonics. One acronym you may already know is HOMES, for the names of the Great Lakes (Huron, Ontario, Michigan, Erie, and Superior). ROY G. BIV reminds people of the colors in the spectrum (Red, Orange, Yellow, Green, Blue, Indigo, and Violet). Depending on the type of learner you are, mnemonics can also be colorful or vivid images, stories, word associations, or catchy rhymes such as “Thirty days hath September . . . ” created in your mind. Any type of learner, whether visual, auditory, or kinesthetic, can use mnemonics to help the brain store and interpret information. Step 4: Learn to Manage Your Time Activities: Practice these strategies as you take the sample tests in this book. Steps 4, 5, and 6 of the LearningExpress Test Preparation System put you in charge of your exam by showing you test-taking strategies that work. Practice these strategies as you take the sample tests in this book, and then you will be ready to use them on test day. First, you will take control of your time on the exam. Most nursing assistant exams have a time limit, which may give you more than enough time to complete all the questions—or may not. It is a terrible feeling to hear the examiner say, “Five minutes left,” when you are only three-quarters of the way through the test. Here are some tips to keep that from happening to you. ■ Follow directions. If the directions are given orally, listen to them. If they are written on the exam booklet, read them carefully. Ask questions before the exam begins if there’s anything you don’t understand. If you are allowed to write in your exam booklet, write down the beginning time and the ending time of the exam. –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 14■ Pace yourself. Glance at your watch every few minutes, and compare the time to how far you have gotten in the test. When one-quarter of the time has elapsed, you should be a quarter of the way through the test, and so on. If you are falling behind, pick up the pace a bit. ■ Keep moving. Don’t dither around on one question. If you don’t know the answer, skip the question and move on. Circle the number of the question in your test booklet in case you have time to come back to it later. ■ Keep track of your place on the answer sheet. If you skip a question, make sure that you also skip the question on the answer sheet. Check yourself every 5–10 questions to make sure that the number of the question still corresponds with the number on the answer sheet. ■ Don’t rush. Though you should keep moving, rushing won’t help. Try to keep calm and work methodically and quickly. Step 5: Learn to Use the Process of Elimination Activity: Complete worksheet on Using the Process of Elimination (see page 17). After time management, your next most important tool for taking control of your exam is using the process of elimination wisely. It is standard test-taking wisdom that you should always read all the answer choices before choosing your answer. This helps you find the right answer by eliminating wrong answer choices. And, sure enough, that standard wisdom applies to your nursing assistant exam, too. Let’s say you are facing a question that goes like this: Which of the following lists of signs and symptoms indicates a possible heart attack? a. headache, dizziness, nausea, confusion b. dull chest pain, sudden sweating, difficulty breathing c. wheezing, labored breathing, chest pain d. difficulty breathing, high fever, rapid pulse You should always use the process of elimination on a question like this, even if the right answer jumps out at you. Sometimes the answer that jumps out isn’t right after all. Let’s assume, for the purpose of this exercise, that you are a little rusty on your signs and symptoms of a heart attack, so you need to use a little intuition to make up for what you don’t remember. Proceed through the answer choices in order. ■ Start with answer a. This one is pretty easy to eliminate; none of these signs and symptoms is likely to indicate a heart attack. Mark an X next to choice a so you never have to look at it again. ■ On to choice b. “Dull chest pain” looks good, though if you are not up on your cardiac signs and symptoms you might wonder if it should be “acute chest pain” instead. “Sudden sweating” and “difficulty breathing”? Check. And that’s what you write next to answer b—a check mark, meaning “good answer, I might use this one.” ■ Choice c is a possibility. Maybe you don’t really expect wheezing in a heart attack victim, but you know “chest pain” is right, and let’s say you are not sure whether “labored breathing” is a sign of cardiac difficulty. Put a question mark next to c, meaning “well, maybe.” ■ Choice d is also a possibility. “Difficulty breathing” is a good sign of a heart attack. But wait a minute. “High fever?” Not really. “Rapid pulse?” Well, maybe. This doesn’t really sound like a heart attack, and you have already got a better answer picked out in choice b. If you are feeling sure of yourself, put an X next to this one. If you want to –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 15be careful, put a question mark. Now your question looks like this: Which of the following lists of signs and symptoms indicates a possible heart attack? X a. headache, dizziness, nausea, confusion ✓ b. dull chest pain, sudden sweating, difficulty breathing ? c. wheezing, labored breathing, chest pain ? d. difficulty breathing, high fever, rapid pulse You have got just one check mark, for a good answer. If you are pressed for time, you should simply mark answer b on your answer sheet. If you have got the time to be extra careful, you could compare your check mark answer to your question-mark answers to make sure that it is better. It is good to have a system for marking good, bad, and maybe answers. We recommend this one: X = bad ✓ = good ? = maybe If you don’t like these marks, devise your own system. Just make sure you do it long before test day— while you are working through the practice exams in this book—so you won’t have to worry about it during the test. Key Words Often, identifying key words in a question will help you in the process of elimination. Words such as always, never, all, only, must, and will often make statements incorrect. Here is an example of an incorrect statement: When a nursing assistant is preparing to ambulate a client, making sure the client is wearing proper footwear will always prevent them from falling. The word always in this statement makes it incorrect. Nursing assistants must also take other measures, in addition to providing proper footwear, when ambulating a resident, such as proper body mechanics and providing support to the client. Words like usually, may, sometimes, and most may make a statement correct. Here is an example of a correct statement: Clients of healthcare facilities and hospitals may need help with tasks such as being fed and bathed. The word may makes this statement correct. There are clients in facilities who may be too ill or weak to perform daily tasks such as feeding and bathing themselves. Even when you think you are absolutely clueless about a question, you can often use the process of elimination to get rid of at least one answer choice. If so, you are better prepared to make an educated guess, as you will see in Step 6. More often, you can eliminate answers until you have only two possible answers. Then you are in a strong position to guess. Try using your powers of elimination on the questions in the following worksheet, Using the Process of Elimination. The questions are not about healthcare work; they are just designed to show you how the process of elimination works. The answer explanations for this worksheet show one possible way you might use the process to arrive at the right answer. Step 6: Know When to Guess Activity: Complete worksheet on Your Guessing Ability (see page 18). Armed with the process of elimination, you are ready to take control of one of the big questions in test taking: Should I guess? The first and main answer is Yes. Some exams have what’s called a “guessing penalty,” in which a fraction of your wrong answers is subtracted from your right answers—but nursing assistant exams –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 16Using the Process of Elimination Use the process of elimination to answer the following questions. 1. Ilsa is as old as Meghan will be in five years. The difference between Ed’s age and Meghan’s age is twice the difference between Ilsa’s age and Meghan’s age. Ed is 29. How old is Ilsa? a. 4 b. 10 c. 19 d. 24 2. “All drivers of commercial vehicles must carry a valid commercial driver’s license whenever operating a commercial vehicle.” According to this sentence, which of the following people need NOT carry a commercial driver’s license? a. a truck driver idling his engine while waiting to be directed to a loading dock b. a bus operator backing her bus out of the way of another bus in the bus lot c. a taxi driver driving his personal car to the grocery store d. a limousine driver taking the limousine to her home after dropping off her last passenger of the evening 3. Smoking tobacco has been linked to a. increased risk of stroke and heart attack b. all forms of respiratory disease c. increasing mortality rates over the past ten years d. juvenile delinquency 4. Which of the following words is spelled correctly? a. incorrigible b. outragous c. domestickated d. understandible 1. d. You should have eliminated answer a off the bat. Ilsa can’t be four years old if Meghan is going to be Ilsa’s age in five years. The best way to eliminate other answer choices is to try plugging them in to the information given in the problem. For instance, for answer b, if Ilsa is 10, then Meghan must be 5. The difference in their ages is 5. The difference between Ed’s age, 29, and Meghan’s age, 5, is 24. Is 24 two times 5? No. Then answer b is wrong. You could eliminate answer c in the same way and be left with answer d. 2. c. Note the word not in the question, and go through the answers one by one. Is the truck driver in choice a “operating a commercial vehicle”? Yes, idling counts as “operating,” so he needs to have a commercial driver’s license. Likewise, the bus operator in answer b is operating a commercial vehicle; the question doesn’t say the operator has to be on the street. The limo driver in choice d is operating a commercial vehicle, even if it doesn’t have a passenger in it. However, the cabbie in answer c is not operating a commercial vehicle, but his own private car. 3. a. You could eliminate answer b simply because of the presence of the word all. Such absolutes hardly ever appear in correct Answers Here are the answers, as well as some suggestions as to how you might have used the process of elimination to find them. 17answer choices. Choice c looks attractive until you think a little about what you know— aren’t fewer people smoking these days, rather than more? So how could smoking be responsible for a higher mortality rate? (If you didn’t know that mortality rate means the rate at which people die, you might keep this choice as a possibility, but you would still be able to eliminate two answers and have only two to choose from.) And choice d is plain silly, so you could eliminate that one, too. You are left with the correct choice, a. 4. a. How you used the process of elimination here depends on which words you recognized as being spelled incorrectly. If you knew that the correct spellings were outrageous, domesticated, and understandable, then you were home free. The following are ten really hard questions. You are not supposed to know the answers. Rather, this is an assessment of your ability to guess when you don’t have a clue. Read each question carefully, just as if you did expect to answer it. If you have any knowledge of the subject, use that knowledge to help you eliminate wrong answer choices. 1. September 7 is Independence Day in a. India b. Costa Rica c. Brazil d. Australia 2. Which of the following is the formula for determining the momentum of an object? a. p = MV b. F = ma c. P = IV d. E = mc2 3. Because of the expansion of the universe, the stars and other celestial bodies are all moving away from each other. This phenomenon is known as a. Newton’s first law b. the big bang c. gravitational collapse d. Hubble flow 4. American author Gertrude Stein was born in a. 1713 b. 1830 c. 1874 d. 1901 5. Which of the following is NOT one of the Five Classics attributed to Confucius? a. the I Ching b. the Book of Holiness c. the Spring and Autumn Annals d. the Book of History 6. The religious and philosophical doctrine that holds that the universe is constantly in a struggle between good and evil is known as a. Pelagianism b. Manichaeanism c. neo-Hegelianism d. Epicureanism 7. The third Chief Justice of the U.S. Supreme Court was a. John Blair b. William Cushing c. James Wilson d. John Jay Using the Process of Elimination (continued) Your Guessing Ability 188. Which of the following is the poisonous portion of a daffodil? a. the bulb b. the leaves c. the stem d. the flowers 9. The winner of the Masters golf tournament in 1953 was a. Sam Snead b. Cary Middlecoff c. Arnold Palmer d. Ben Hogan 10. The state with the highest per capita personal income in 1980 was a. Alaska b. Connecticut c. New York d. Texas Answers Check your answers against the correct answers below. 1. c. 2. a. 3. d. 4. c. 5. b. 6. b. 7. b. 8. a. 9. d. 10. a. How Did You Do? You may have simply gotten lucky and actually known the answer to one or two questions. In addition, your guessing was probably more successful if you were able to use the process of elimination on any of the questions. Maybe you didn’t know who the third Chief Justice was (question 7), but you knew that John Jay was the first. In that case, you would have eliminated answer d and therefore improved your odds of guessing right from one in four to one in three. According to probability, you should get two and a half answers correct, so getting either two or three right would be average. If you got four or more right, you may be a really terrific guesser. If you got one or none right, you may be a really bad guesser. Keep in mind, though, that this is only a small sample. You should continue to keep track of your guessing ability as you work through the sample questions in this book. Circle the numbers of questions you guess on as you make your guess; or, if you don’t have time while you take the practice tests, go back afterward and try to remember which questions you guessed at. Remember, on a test with four answer choices, your chance of guessing correctly is one in four. So keep a separate “guessing” score for each exam. How many questions did you guess on? How many did you get right? If the number you got right is at least onefourth of the number of questions you guessed on, you are at least an average guesser—maybe better—and you should always go ahead and guess on the real exam. If the number you got right is significantly lower than one-fourth of the number you guessed on, you would, frankly, be safe in guessing anyway, but maybe you would feel more comfortable if you guessed only selectively, when you can eliminate a wrong answer or at least have a good feeling about one of the answer choices. Frankly, even if you are a play-it-safe person with lousy intuition, you are still safe guessing every time. Your Guessing Ability (continued) 19don’t tend to work like that. The number of questions you answer correctly yields your raw score. So you have nothing to lose and everything to gain by guessing. The more complicated answer to the question “Should I guess?” depends on you—your personality and your “guessing intuition.” There are two things you need to know about yourself before you go into the exam: Are you a risk-taker? Are you a good guesser? You will have to decide about your risk-taking quotient on your own. To find out if you are a good guesser, complete the worksheet, Your Guessing Ability on page 18. Step 7: Reach Your Peak Performance Zone Activity: Complete the Physical Preparation Checklist. To get ready for a challenge like a big exam, you have to take control of your physical, as well as your mental, state. Exercise, proper diet, and rest in the weeks prior to the test will ensure that your body works with, rather than against, your mind on test day, as well as during your preparation. Exercise If you don’t already have a regular exercise program going, the time during which you are preparing for an exam is actually an excellent time to start one. And if you are already keeping fit—or trying to get that way—don’t let the pressure of preparing for an exam fool you into quitting now. Exercise helps reduce stress by pumping feel-good hormones, called endorphins, into your system. It also increases the oxygen supply throughout your body, including your brain, so you will be at peak performance on test day. A half hour of vigorous activity—enough to raise a sweat—every day should be your aim. If you are really pressed for time, every other day is OK. Choose an activity you like and get out there and do it. Jogging with a friend always makes the time go faster, or take a portable radio or CD player. But don’t overdo it. You don’t want to exhaust yourself. Moderation is the key. Diet First of all, cut out the junk. Go easy on caffeine and nicotine, and eliminate alcohol from your system at least two weeks before the exam. What your body needs for peak performance is simply a balanced diet. Eat plenty of fruits and vegetables, along with protein and carbohydrates. Foods that are high in lecithin (an amino acid), such as fish and beans, are especially good “brain foods.” The night before the exam, you might “carboload” the way athletes do before a contest. Eat a big plate of spaghetti, rice and beans, or whatever your favorite carbohydrate is. Rest You probably know how much sleep you need every night to be at your best, even if you don’t always get it. Make sure you do get that much sleep, though, for at least a week before the exam. Moderation is important here, too. Extra sleep will just make you groggy. If you are not a morning person and your exam will be given in the morning, you should reset your internal clock so that your body doesn’t think you are taking an exam at 3 A.M. You have to start this process well before the exam. The way it works is to get up half an hour earlier each morning, and then go to bed half an hour earlier that night. Don’t try it the other way around; you will just toss and turn if you go to bed early without having gotten up early. The next morning, get up another half an hour earlier, and so on. How long you will have to do this depends on how late you are used to getting up. –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 20 Step 8: Get Your Act Together Activity: Complete Final Preparations worksheet. You are in control of your mind and body; you are in charge of test anxiety, your preparation, and your testtaking strategies. Now it is time to take charge of external factors, like the testing site and the materials you need to take the exam. Find Out Where the Test Is and Make a Trial Run The testing agency or your nursing assistant instructor will notify you when and where your exam is being held. Do you know how to get to the testing site? Do you know how long it will take to get there? If not, make a trial run, preferably on the same day of the week at the same time of day. Make note, on the worksheet Final Preparations on page 22, of the amount of time it will take you to get to the exam site. Plan on arriving at least 10–15 minutes early so you can get the lay of the land, use the bathroom, and calm down. Then figure out how early you will have to get up that morning, and make sure you get up that early every day for a week before the exam. Gather Your Materials The night before the exam, lay out the clothes you will wear and the materials you have to bring with you to the exam. Plan on dressing in layers; you won’t have any control over the temperature of the examination room. Have a sweater or jacket you can take off if it is warm. Use the checklist on the worksheet Final Preparations on the following page to help you pull together what you will need. Don’t Skip Breakfast Even if you don’t usually eat breakfast, do so on exam morning. A cup of coffee doesn’t count. Don’t eat doughnuts or other sweet foods, either. A sugar high will leave you with a sugar low in the middle of the exam. A mix of protein and carbohydrates is best: cereal with milk and just a little sugar, or eggs with toast, will do your body a world of good. Step 9: Do It! Activity: Ace the nursing assistant exam! Fast forward to exam day. You are ready. You made a study plan and followed through. You practiced your test-taking strategies while working through this book. You are in control of your physical, mental, and emotional states. You know when and where to show up and what to bring with you. In other words, you are better prepared than most of the other people taking the nursing assistant exam with you. You are psyched. Just one more thing. . . . When you are done with the exam, you deserve a reward. Plan a celebration. Call up your friends and plan a party, or have a nice dinner for two—whatever your heart desires. Give yourself something to look forward to. And then do it. Go into the exam, full of confidence, armed with test-taking strategies you have practiced until they are second nature. You are in control of yourself, your environment, and your performance on the exam. You are ready to succeed. So do it. Go in there and ace the exam. And look forward to your future career as a nursing assistant! –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 21Getting to the Exam Site Location of exam site: Date: Departure time: Do I know how to get to the exam site? Yes No (If no, make a trial run.) Time it will take to get to exam site: Things to Lay Out the Night Before Clothes I will wear Sweater/jacket Watch Photo ID Four #2 pencils Other Things to Bring/Remember Final Preparations 22 Schedule A: The 30-Day Plan If you have at least a month before you take the nursing assistant exam, you have plenty of time to prepare—as long as you don’t waste it! If you have less than a month, turn to Schedule B. –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 23 Time Preparation Days 1–3 Skim over the written materials from your training program, particularly noting any areas you expect to be emphasized on the exam or any areas you don’t remember well. Day 4 Take the first practice exam in Chapter 3. Day 5 Score the first practice exam. Based on this exam, identify your strongest and weakest areas. Pick two areas that you will concentrate on before you take the second practice exam. Days 6–8 Study the two areas you identified as your weak points. Don’t worry about the other areas. Days 9–10 Take the second practice exam in Chapter 4. Day 11 Score the second practice exam. Identify one area to concentrate on before you take the third practice exam. Days 12–16 Study the one area you identified for review. In addition, review both practice exams you have taken so far, with special attention to the answer explanations. Time Preparation Day 17 Take the third practice exam. Day 18 Once again, identify one area to review, based on your score on the third practice exam. Days 19–20 Study the one area you identified for review. Days 21–23 Take an overview of all your training materials, consolidating your strengths and improving on your weaknesses. Days 24–25 Review all the areas that have given you the most trouble in the three practice exams you have taken so far. Day 26 Take the fourth practice exam in Chapter 6. Note how much you have improved! Days 27–28 Review any areas in which you still feel unsure. Day 29 Take the final practice exam. Day before Relax. Do something unrelated to the the exam exam and go to bed at a reasonable hour. Schedule B: The 10-Day Plan If you have two weeks or less before you take the exam, you may have your work cut out for you. Use this 10-day schedule to help you make the most of your time. –THE LEARNINGEXPRESS TEST PREPARATION SYSTEM– 24 Time Preparation Day 1 Take the first practice exam in Chapter 3 and score it using the answer key at the end. Identify which skill areas need the most work, based on your exam score. Day 2 Review one area that gave you trouble on the first practice exam. Day 3 Review another area that gave you trouble on the first practice exam. Day 4 Take the second practice exam in Chapter 4 and score it. Day 5 If your score on the second practice exam doesn’t show improvement on the two areas you studied, review them. If you did improve in those areas, choose a new weak area to study today. Time Preparation Day 6 Take the third practice exam in Chapter 5 and score it. Day 7 Choose your weakest area from the third practice exam to review. Day 8 Review any areas that you have not yet reviewed in this schedule. Day 9 Take the fourth practice exam in Chapter 6 and score it. Day 10 Use your last study day to brush up on any areas that are still giving you trouble and then take the fifth practice exam. Day before Relax. Do something unrelated to the the exam exam and go to bed at a reasonable hour.IF YO U A R E much like this one, based on the NNAAP. This exam has 70 multiple-choice questions covering the range of duties performed by a certified nursing assistant: required to take a written exam in order to be certified, the exam you take is likely to be very ■ Physical Care Skills—activities of daily living, basic nursing skills, restorative skills ■ Psychosocial Care Skills—emotional- and mental-health needs, spiritual and cultural needs ■ Role of the Nurse Aide—communication, client rights, legal and ethical behavior as a member of the healthcare team The exam is not divided into these sections; you may find questions on very different topics right next to each other. The first ten questions are a short Pretest to get you warmed up—don’t count them as part of your score. These questions are designed to familiarize you with the types of questions you will see on the test. Normally you would have two hours to complete a test like this, but for now, don’t worry about timing. Just answer all of the questions at one sitting. The answer sheet you should use for filling in your answers is on the C H A P T E R Nursing Assistant/Nurse Aide Practice Exam 1 CHAPTER SUMMARY This is the first of five practice exams in this book based on the National Nurse Aide Assessment Program (NNAAP) written exam. Use this first test to identify your areas of strength and weakness. 3 25next page. After the exam is an answer key, with all the answers explained. These explanations will help you see your areas of strength and weakness. Then you will know which parts of your training materials to study before you take the second practice exam. You can refer to Appendix A for a breakdown of the question types. The chart will help you understand which kinds of questions are most difficult for you so you can focus on those skills for next time. Generally, a score of 75% or more is considered passing. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 26–NURSING ASSISTANT/NURSE AIDE ANSWER SHEET– 27 Practice Pretest Exam 1 1. a b c d 2. a b c d 3. a b c d 4. a b c d 5. a b c d 6. a b c d 7. a b c d 8. a b c d 9. a b c d 10. a b c d 1. a b c d 2. a b c d 3. a b c d 4. a b c d 5. a b c d 6. a b c d 7. a b c d 8. a b c d 9. a b c d 10. a b c d 11. a b c d 12. a b c d 13. a b c d 14. a b c d 15. a b c d 16. a b c d 17. a b c d 18. a b c d 19. a b c d 20. a b c d 21. a b c d 22. a b c d 23. a b c d 24. a b c d 25. a b c d 26. a b c d 27. a b c d 28. a b c d 29. a b c d 30. a b c d 31. a b c d 32. a b c d 33. a b c d 34. a b c d 35. a b c d 36. a b c d 37. a b c d 38. a b c d 39. a b c d 40. a b c d 41. a b c d 42. a b c d 43. a b c d 44. a b c d 45. a b c d 46. a b c d 47. a b c d 48. a b c d 49. a b c d 50. a b c d 51. a b c d 52. a b c d 53. a b c d 54. a b c d 55. a b c d 56. a b c d 57. a b c d 58. a b c d 59. a b c d 60. a b c d Pretest Practice 1. When assisting a client in learning to use a walker, it is important to a. stand behind him and use a transfer belt. b. put padding all the way around the top rim. c. let him walk by himself so he gains independence. d. let him practice using the walker on the day he is discharged. 2. Urinary retention refers to a. normal output of urine. b. inability to urinate. c. incontinence. d. large output of urine. 3. Normal hearing loss in aging is usually related to the ability to hear a. high-pitched sounds. b. loud sounds. c. all sounds. d. rapid speech. 4. The best way to safely identify your patient is by a. asking his name. b. calling his name and waiting for his response. c. checking the bed plate. d. checking the name tag. 5. OSHA rules specify that, when washing out soiled linens, the following must be worn a. gloves b. goggles c. gloves and goggles d. gloves, goggles, and apron 6. The proper medical abbreviation for before meals is a. p.c. b. b.i.d. c. a.c. d. t.i.d. 7. The proper medical term for high blood pressure is a. diabetes. b. hypertension. c. hypotension. d. CVA. 8. A patient who has difficulty chewing or swallowing will need what type of diet? a. clear liquid b. low residue c. bland d. mechanical soft 9. When shaving a male patient’s face, it is important to a. apply shaving cream sparingly. b. use upward strokes when shaving the cheeks. c. apply Betadine to any nicks. d. none of the above 10. How often should a patient’s intake and output records be totaled? a. once each shift b. twice a day c. every 4 hours d. every 12 hours –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 29 Exam 1 1. Which of the following should you observe and record when admitting a client? a. color of the stool and amount of urine voided b. how much the client has eaten and drunk c. bruises, marks, rashes, or broken skin d. insurance information 2. When responding to a client on the intercom, you should a. ask for the client’s name. b. say, “What do you want?” c. give your name and position and say “may I help you?” d. say, “The nurse will answer your call.” 3. Which of the following things should you do to familiarize a new client with his or her surroundings? a. Show the client where the call light is and how to work it. b. Tell the client not to operate the TV. c. Ask visitors to leave the room while you finish admitting the client. d. Raise the side rails of the bed and raise the bed to high position. 4. When arranging a patient’s room, you should do all of the following EXCEPT a. check signal cords. b. adjust the back and knee rests as directed. c. administer medications. d. check lighting. 5. When assisting a client in and out of bed, the nurse aide should always a. employ body mechanic techniques. b. get another person to help. c. pull the client’s feet out first, and then lift the back up. d. put shoes on the client because the patient may slip. 6. When should you wash your hands? a. when you notice they look or feel dirty b. when the charge nurse tells you to c. at least twice a day d. before and after contact with a patient 7. Which of the following is the correct procedure for serving a meal to a client who must be fed? a. serve the tray along with all the other trays, and then come back to feed the client b. bring the tray to the client last; feed after you have served all the other clients c. bring the tray into the room when you are ready to feed the client d. have the kitchen hold the tray for one hour 8. The MOST serious problem that wrinkles in the bedclothes can cause is a. restlessness. b. sleeplessness. c. decubitus ulcers. d. bleeding and shock. 9. An important way to reduce the incidence of decubitus ulcers is to a. keep the client in bed. b. force fluids every 2 hours. c. change position every 2 hours. d. all of the above –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 3010. You are told to put a client in Fowler’s position. Before changing the position of the client’s bed, you should a. open the window. b. explain the procedure to the client. c. check with the client’s family. d. remake the bed. 11. During hand washing, the nurse aide accidentally touches the inside of the sink while rinsing the soap off. The NEXT action is to a. allow the water to run over the hands for two minutes. b. dry the hands and turn off the faucet with the paper towel. c. repeat the wash from the beginning. d. none of the above 12. When giving mouth care to an unconscious patient, the safest position to prevent aspiration is a. on her or his back. b. in semi-Fowler’s position. c. with the head turned to the side. d. in the supine position. 13. Mr. Roark, a newly admitted conscious client, has been put to bed. Before leaving him alone, the FIRST action would be to a. ask him if he is hungry. b. inspect his skin. c. complete the listing of his clothing and valuables. d. make sure he knows how to use the call light. 14. When lifting a heavy object, the correct method would be to bend at the a. waist, keeping your legs straight. b. waist, rounding your shoulders. c. knees, keeping your back straight. d. knees and waist. 15. When cleaning a client’s dentures at the sink, the reason to either line the emesis basin with a paper towel or to fill the sink with water is to a. prevent contamination of the dentures. b. hide the dentures from view. c. guard against breaking the dentures. d. protect the basin from scratches. 16. When assisting a client with eating, one of the FIRST things the nurse aide should do is a. cut the food into large bite-size pieces. b. wash his/her hands and the client’s hands. c. butter the client’s bread. d. provide the client with privacy. 17. A patient has a new cast on his right arm. While caring for him, it is important to FIRST observe for a. pulse above the cast. b. color and hardness of the cast. c. warmth and color of fingers. d. signs of crumbling at the cast end. 18. Encouraging a client to take part in activities of daily living (ADLs) such as bathing, combing hair, and feeding is a. done only when time permits. b. the family’s responsibility. c. necessary for rehabilitation. d. a violation of client rights. 19. In caring for a confused elderly man, it is important to remember to a. keep the bedrails up except when you are at the bedside. b. close the door to the room so that he does not disturb other patients. c. keep the room dark and quiet at all times to keep the patient from becoming upset. d. remind him each morning to shower and shave independently. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 3120. Before assisting a client into a wheelchair, the FIRST action would be to check if the a. client is adequately covered. b. floor is slippery. c. door to the room is closed. d. wheels of the chair are locked. 21. While giving an unconscious patient a bath, it is important to a. give passive range of motion to all joints. b. let the charge nurse exercise the patient’s joints. c. call the physical therapist to exercise the patient afterwards. d. exercise the patient only if the doctor has ordered it. 22. You are assigned to assist Mrs. Kelley with her lunch. She is on bed rest. The BEST position for her, if permitted, would be a. Tredelenberg position. b. hyperextension. c. legs dangling at the side of the bed. d. Fowler’s position. 23. When moving a wheelchair onto an elevator, you should stay a. behind the chair, pulling it toward you. b. behind the chair, pushing it away from you. c. in front of client to observe his or her condition. d. to the side and hold the door open. 24. The Foley bag must be kept lower than the client’s bladder so that a. urine will not leak out, soiling the bed. b. urine will not return to the bladder, causing infection. c. the bag will be hidden and the client will not be embarrassed. d. the client will be more comfortable in bed. 25. Mrs. Black is a diabetic. For her midafternoon nourishment, the kitchen has sent a carton of chocolate ice cream. Your FIRST action should be to a. substitute diet cola for ice cream. b. hold the nourishment and report to the charge nurse. c. ask the secretary to notify the kitchen of an error. d. ask Mrs. Black if she likes ice cream. 26. When assisting a client to use the bedside commode, it is important to a. leave the call light within reach. b. place toilet tissue close by. c. return to check on the client periodically. d. all of the above 27. When assisting Mr. Byrd, a blind client, with his meal, it is NECESSARY to a. sit next to him to help. b. identify each item on his tray. c. feed him so he won’t spill his food. d. insist that he use only a spoon. 28. The purpose of cold applications is usually to a. speed the flow of blood to the area. b. prevent heat exhaustion. c. prevent or reduce swelling. d. prevent the formation of scar tissue. 29. The hot water bottle is an example of a a. local dry heat application. b. generalized dry heat application. c. local moist heat application. d. generalized moist heat application. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 3230. Clients receiving an enema are usually placed a. on the right side. b. on the left side. c. flat on the back. d. in a semisitting position. 31. A female client’s perineal area should be cleansed before which specimen is collected? a. 24-hour urine specimen b. midstream clean-catch urine specimen c. pediatric routine urine specimen d. routine urine specimen 32. The most common site for counting the pulse is the a. carotid artery. b. femoral artery. c. brachial artery. d. radial artery. 33. When counting respirations, the nurse aide should a. wait until after the client has exercised. b. not tell the patient what you are going to do. c. count five respirations and then check your watch. d. have the client count respirations while you take her pulse. 34. With catheterized patients, which of the following is NOT the nurse aide’s responsibility? a. insertion of catheter b. prevention of infection c. checking to make sure the catheter is draining properly d. recording output 35. When giving information to the charge nurse for an incident report, the nurse aide should a. write in the client’s chart that an incident occurred. b. keep the report in your personal file. c. state the facts clearly. d. give your opinions as to the cause of the incident. 36. All long-term-care nurse aides must be competency evaluated and must complete a distinct educational course. These requirements are set by a. OBRA. b. OSHA. c. CDC. d. FDA. 37. Sexuality changes in aging can result in a. decreased sexual desire. b. unchanged sexual desire. c. increased sexual desire. d. all of the above 38. When family members visit a client, the visitors should a. stay in the day room. b. stay a short while so as not to tire the client. c. be expected to help with care. d. be allowed privacy with the client. 39. You may attend resident council meetings in an eldercare facility (ECF) if a. you are invited to attend. b. your superior assigns you to attend. c. you are interested in what the residents are discussing. d. none of the above –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 3340. Which of the following is considered a client’s right? a. having curtains pulled during personal care b. having personal information kept confidential c. receiving and sending private mail d. all of the above 41. An ECF resident wishes to wash her own underwear. You should a. ignore the request. b. tell her that clothing must go to the laundry. c. tell her you will do it. d. help her obtain supplies. 42. In the long-term-care facility, the family members should be asked to a. leave during treatments. b. attend care-planning meetings. c. avoid visiting during mealtimes. d. help perform client care. 43. Sexuality in long-term-care clients may include all of the following except a. needing private time with a partner. b. caring about one’s physical appearance. c. engaging in public fondling. d. desiring sexual interaction. 44. Which statement about some patients with developmental disabilities is correct? a. They usually have no ADL skills. b. They are usually bed bound. c. They can learn, but at a slow pace. d. They are dangerous because they are always strong. 45. A goal for an ECF resident is that she not swear at the nurses or aides. When she calls you by your name, your appropriate action is to a. smile and give the appropriate reward. b. continue whatever task that is being done. c. tease the resident about not swearing. d. tell all of the staff that she didn’t swear. 46. An agitated resident must be turned every two hours all night long. The first action of the nurse aide when waking up this resident is to a. turn on the light. b. speak quietly and calmly. c. touch her shoulder. d. shout her name. 47. If a client objects to certain food for religious or cultural reasons, the appropriate action would be to a. tell him to wait for the next meal. b. offer to substitute something different for him. c. call the dietician on the next day. d. tell him he needs to eat what is on his tray. 48. The client’s religion forbids eating pork. Bacon is being served for breakfast. The MOST appropriate response is to a. encourage the client to eat it because she needs protein. b. tell the client it is all right since her doctor ordered the diet. c. call the kitchen for a tray without bacon. d. tell the client that restrictions don’t pertain in times of illness. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 3449. If a client asks a question you cannot answer, the best response is to a. tell the client you will ask another aide. b. ask the charge nurse to talk to the client. c. call the doctor to talk to the client. d. tell the client that you cannot answer the question. 50. Before bathing a client, the nursing assistant should a. close the door and pull the curtain. b. gather a change of clothing. c. check for a doctor’s order. d. all of the above 51. On entering a room, you notice that the client is not breathing. Your FIRST action should be to a. call for help. b. lay the client down on his back. c. give four quick breaths. d. give 8–10 abdominal thrusts. 52. A client’s dentures are lost. The first action would be to a. notify the administrator. b. look for them. c. notify the doctor. d. notify the charge nurse. 53. As a nurse aide, it is your responsibility to a. plan the client’s care. b. do the tasks the supervisor assigns to you. c. do the best you can without asking for help. d. compare assignments with your coworkers. 54. A patient turns on the call light when he needs to urinate. The appropriate action is to a. ignore the light since he is not your client. b. announce on the intercom that there are two patients ahead of him. c. answer the call light and get the urinal. d. answer the call light when you have the time. 55. A prosthesis is a. an artificial substitute for a missing body part. b. a device for moving patients. c. an expected condition of the aging process. d. a disease of the circulatory system. 56. When performing catheter care, the nurse aide should wash the catheter a. toward the meatus. b. with Betadine soap. c. away from the meatus. d. with alcohol. 57. A nurse aide who applies restraints on a client without directions from the charge nurse may be accused of a. slander. b. battery. c. false imprisonment. d. negligence. 58. H.S. care is care that is given a. before meals. b. before bedtime. c. after meals. d. upon awakening. –CHAPTER TITLE– 35 –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1–59. The BEST food choices for a geriatric client with no teeth would include a. hamburger, french fries, corn, and ice cream. b. baked chicken, dressing, green beans, and coconut macaroons. c. spare ribs, macaroni and cheese, coleslaw, and fruit cocktail. d. baked fish, whipped potatoes, spinach soufflé, and tapioca. 60. The family wants to talk about Bill’s approaching death, but Bill does not. The family should be encouraged to a. carry on the conversation away from Bill. b. talk freely in the room regardless of Bill’s wishes. c. wait until Bill dies. d. try to encourage Bill to take part in the conversation. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 36Pretest Practice 1. a. Standing behind him and using a transfer belt protects both the client and the aide. 2. b. Retention of urine is a symptom that should be reported to the charge nurse as soon as it is noted. 3. a. Because of this aspect of hearing loss, the aged hear better if you lower your voice. Shouting in a high-pitched voice does not help. 4. d. A confused patient may answer to any name or lie down in any bed. 5. c. To protect yourself, you must wear gloves and goggles. 6. c. The proper medical abbreviation for before meals is a.c. 7. b. The proper medical term for high blood pressure is hypertension. 8. d. A mechanical soft diet is easy to chew, swallow, and digest. 9. d. All of the answers a–c are wrong. 10. a. Input and output are totaled once per shift as well as every 24 hours. Exam 1 1. c. Failure to notice bruises or marks on the skin on admission may later cause someone to believe you were involved in abuse. 2. c. When responding to a patient on the intercom, you should give your name and position. 3. a. You should never leave a new admit until the patient knows how to call for help. 4. c. Nursing assistants are never allowed to give medications. 5. a. You should always use good body mechanics when moving patients. 6. d. You should wash your hands before and after contact with a patient. 7. c. You should not bring the tray into the room until you have time to feed. 8. c. The most serious problem that wrinkles in the bedclothes can cause patients are decubitus ulcers, or decubiti. 9. c. Changing the patient’s position every two hours prevents bedsores. 10. b. You should always explain procedures first, so b is the correct answer. 11. c. You have contaminated your hands and must start over. 12. c. Turning the head to the side will assist in drainage out of the mouth. 13. d. Always make sure new patients can call for help. 14. c. Keeping your back straight forces you to use your strong leg muscles. 15. c. The purpose of this procedure is to prevent breakage. 16. b. Always remember to consider infection control. 17. c. A new cast may cut off circulation. Choice c reminds you to check for circulatory impairment. 18. c. Rehabilitation should always be part of the care plan. 19. a. Make sure to follow agency policy. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 37 Answers and Explanations20. d. Before assisting a patient into a wheelchair, check to see if the wheels of the chair are locked. 21. a. Passive ROM should always be given with the bath on an unconscious patient. 22. d. Semi-Fowler’s position is correct because the patient is on bed rest. 23. a. You must stay behind the chair to control it, but it should go on and come off an elevator backwards to prevent the wheels from falling into the door opening. 24. b. Raising the bag above the bladder level can lead to backflow of the urine, with its bacteria, into the bladder. 25. b. Always report abnormal conditions. 26. d. All of the answers listed are correct. 27. b. A blind patient should know what you are giving him before it enters his mouth. 28. c. The purpose of cold applications is usually to prevent or reduce swelling. 29. a. A hot water bottle applied by itself is dry heat. 30. b. Placing the patient on the left side allows better entry into the colon. 31. b. The clean-catch specimen requires cleaning the perineum. 32. d. The other sites are rarely used by the nursing assistant. 33. b. Telling the patient you are watching her breathing will cause her to slightly change her breathing pattern. 34. a. A nursing assistant is responsible for the other options but never inserts a catheter. 35. c. An incident report becomes a permanent part of the legal record. Make sure the facts are clear. 36. a. OBRA stands for the Omnibus Budget and Reform Act. 37. d. Sexual desire is related to emotions as well as physical ability, so all the answers listed may be correct for different individuals. 38. d. The family members should expect and be allowed private time with their loved one. 39. a. The resident council is a meeting of the residents, and no staff may attend unless invited. 40. d. All of the answers given are rights of the resident. 41. d. The patient has the right to wash her own clothes if she so wishes. You must help her to do so. 42. b. Federal law states that residents have the right to have family involvement in care planning. 43. c. As long-term-care providers, nursing assistants must respect the resident’s right to sexuality. However, engaging in public fondling is inappropriate and may infringe on other residents’ rights. 44. c. Patients with mental retardation are all different. The important thing to remember is that many of them can learn; those who can just do so more slowly than other people. 45. a. You want to positively reinforce the resident’s appropriate behavior, so smiling and rewarding her good behavior is the best action. 46. b. Do not startle the resident, as this may agitate her. Speak as you enter the room. 47. b. Consideration of cultural or religious beliefs is important to all patients. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 3848. c. The other answers do not address the resident’s right to practice their religion. 49. b. Always refer such questions to the charge nurse to handle. 50. a. Choice b is incorrect because some residents are capable of choosing their own clothing. Choice c is incorrect because there will not be a doctor’s order for a bath. Choice d, therefore, is also incorrect. 51. a. Always call for help first in an emergency. 52. d. The first step for any lost belongings is always to notify the charge nurse. 53. b. Choice a is incorrect because you are a member of the planning team, not the major planner. Choice c is incorrect because in healthcare the correct action is often to ask for help. Choice d is incorrect because there is no legitimate reason to compare notes with coworkers. 54. c. Answer any call light as soon as possible. 55. a. Examples of prostheses include artificial limbs, hearing aids, and dentures. 56. c. You should follow the clean-to-dirty principle, with the meatus considered cleaner than the catheter tubing. 57. c. Applying restraints without an order/without consent can be considered false imprisonment. 58. b. H.S. is the abbreviation for hour of sleep. 59. d. Of the choices listed, only d is a soft diet. 60. a. Involve Bill if he chooses, but have the family talk privately otherwise. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1– 39LI K E T H E F I R S T ing assistants. Now that you have taken one exam, you should be more comfortable with the format. If you followed the advice of this book and went back to your training materials to brush up on the exam in this book, the exam in this chapter follows the NNAAP for certified nursareas you had trouble with in the first exam, you will probably do better on the second exam. When you finish the exam, check your answers against the answer key that follows the exam. Read the explanations carefully; they will help you see why you missed the questions you did. You can also use the explanations to help you brush up on areas that give you trouble. Then refer to the chart in Appendix A to see which kinds of questions were the most difficult for you. You should also go back to review your training materials and textbook, focusing on these areas in particular before you take the third practice exam. C H A P T E R Nursing Assistant/Nurse Aide Practice Exam 2 CHAPTER SUMMARY This is the second of five practice exams in this book based on the National Nurse Aide Assessment Program (NNAAP) written exam. This exam will give you more practice with the kinds of questions you are likely to see on the exam. 4 41–NURSING ASSISTANT/NURSE AIDE ANSWER SHEET– 43 Pretest Practice Exam 2 1. a b c d 2. a b c d 3. a b c d 4. a b c d 5. a b c d 6. a b c d 7. a b c d 8. a b c d 9. a b c d 10. a b c d 1. a b c d 2. a b c d 3. a b c d 4. a b c d 5. a b c d 6. a b c d 7. a b c d 8. a b c d 9. a b c d 10. a b c d 11. a b c d 12. a b c d 13. a b c d 14. a b c d 15. a b c d 16. a b c d 17. a b c d 18. a b c d 19. a b c d 20. a b c d 21. a b c d 22. a b c d 23. a b c d 24. a b c d 25. a b c d 26. a b c d 27. a b c d 28. a b c d 29. a b c d 30. a b c d 31. a b c d 32. a b c d 33. a b c d 34. a b c d 35. a b c d 36. a b c d 37. a b c d 38. a b c d 39. a b c d 40. a b c d 41. a b c d 42. a b c d 43. a b c d 44. a b c d 45. a b c d 46. a b c d 47. a b c d 48. a b c d 49. a b c d 50. a b c d 51. a b c d 52. a b c d 53. a b c d 54. a b c d 55. a b c d 56. a b c d 57. a b c d 58. a b c d 59. a b c d 60. a b c d Pretest Practice 1. Decubitus ulcers may develop in clients who are a. incontinent. b. paralyzed. c. poorly nourished. d. all of the above 2. A walker may be used if the client can a. support some weight. b. use her hands well. c. balance without help. d. walk independently. 3. A cane should be used on a. the affected (weak) side of the body. b. the unaffected (strong) side of the body. c. the side with the strongest arm. d. the weak side one day, strong side next day. 4. Which of the following statements about ROM is FALSE? a. Active ROM means the client does the exercises. b. Passive ROM means the nursing assistant does the exercises. c. Active ROM means the resident does the exercises. d. Active ROM is best, if possible. 5. When helping a client use a walker, it is important to tell him to a. move the walker and his feet at the same time. b. move the walker, place the walker firmly, and step. c. move the walker and then slide his feet. d. take several steps, slide the walker, and then place the walker firmly. 6. The purpose of correctly positioning the client is to a. prevent skin breakdown. b. maintain function of joints and muscles. c. increase comfort. d. all of the above 7. Which of the following statements about dressing ECF residents is true? a. It is not necessary for handicapped residents to dress in street clothes. b. Residents like staff members to dress them. c. Residents are concerned about how they look. d. Residents are used to being dressed in front of others. 8. The preferred way to remove a bedpan from a client who is unable to lift her buttocks is to a. use a mechanical lifting device. b. have another nursing assistant lift the client. c. turn the client to the side while holding the pan. d. slowly slide the pan from under the client. 9. At the beginning of your shift, you give a client a water pitcher containing 270 cc (9 oz.) of water. At the end of your shift, you note that 35 cc of water is left in the pitcher. How much water has been consumed? a. 35 cc b. 135 cc c. 175 cc d. 235 cc 10. When a client complains that his dentures are hurting, the appropriate action is to a. encourage him to wear the dentures more often. b. report the complaint to the charge nurse. c. report the complaint to the physician. d. put the dentures on the bedside table. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2– 45 Exam 2 1. A water pitcher has tipped over and you notice water on the floor. The BEST action is to a. wipe it up immediately. b. throw a towel over the water to prevent accidents. c. notify the charge nurse. d. call housekeeping. 2. On entering a room, you notice that the patient is not breathing. Your FIRST action should be to a. call for help. b. lay the resident down on his back. c. give four quick breaths. d. give 8–10 abdominal thrusts. 3. When making an occupied bed, it is important to a. make half of the bed at one time. b. have one side rail up and one down. c. make a toe pleat in the top covers. d. all of the above 4. Decubitus ulcers can be prevented by a. changing the client’s position frequently. b. placing an egg-crate mattress on top of the mattress. c. increasing the patient’s vitamin C consumption. d. both a and b 5. The first step in getting a client up to walk is to a. sit the client on the side of the bed. b. put the client’s slippers on. c. check the activity order. d. tell the client what you want him to do. 6. The patient’s TPR is 98.8-80-30. The finding that should be reported at once is a. pulse. b. temperature. c. respiration. d. all of the above 7. Which of the following can cause an inaccurate oral temperature reading? a. drinking hot or cold liquids within ten minutes of the reading b. failure to shake down a mercury thermometer c. vigorous exercise prior to measuring temperature d. all of the above 8. Systolic blood pressure is determined by a. reviewing previous readings. b. listening for the first clear sound. c. waiting for a change in sound. d. listening for the last clear sound. 9. The order “weigh client q.o.d.” means to weigh the client every a. other week. b. other day. c. morning. d. week. 10. The FIRST step in performing any procedure is to a. explain the procedure. b. gather needed equipment. c. wash your hands. d. provide privacy. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2– 4611. Which of the following procedures best destroys all bacteria? a. soaking in alcohol b. washing with bleach c. sterilizing d. all of the above 12. In the event of a fire in a client’s room, your FIRST action should be to a. notify the charge nurse. b. turn in a fire alarm. c. get the client to a safe place. d. get the fire extinguisher. 13. Safe use of oxygen therapy includes a. always setting the flow meter at 2–3 liters per minute. b. using wool blankets only. c. cleansing the nasal prongs each shift with alcohol. d. posting a “no smoking” sign on the door. 14. When you perform CPR, the client should be lying a. flat on a hard surface. b. with head and shoulders elevated. c. with the head and feet raised slightly. d. none of the above 15. A procedure manual is a a. written set of instructions on how to perform procedures. b. set of directions needed to complete your job description. c. book of directions for administering medications. d. book listing the procedures you have been assigned to do. 16. If a client cannot speak English, the nurse aide should a. have the family interpret. b. ask the charge nurse to arrange for an interpreter. c. call the doctor to talk to the client. d. tell the client that you cannot answer the question. 17. The accepted way to identify a client is to a. check the bed name and number. b. check the identification band. c. ask the client’s name. d. call the client by name. 18. Which of the following best describes nail care? a. Nail care is not needed for the elderly. b. Use scissors for all nail care. c. All clients need nail care. d. Check with the charge nurse for nail-care instructions. 19. When performing perineal care on a male, always a. clean the scrotum first. b. retract the foreskin if uncircumcised. c. clean from front to back. d. hold the penis at a 90-degree angle. 20. The reasons for rubbing a client’s back include a. improving circulation. b. increasing one-on-one interaction time. c. relaxing the client. d. all of the above 21. The client’s elbows are dry and red. You should a. report this to the charge nurse. b. rub them with lotion. c. apply elbow protectors. d. all of the above –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2– 4722. A decubitus ulcer is caused by a. poor circulation. b. pressure on the skin. c. poor nutrition. d. all of the above 23. You would shampoo a client’s hair to improve a. circulation to the scalp. b. the client’s general appearance. c. the client’s feeling of well-being. d. all of the above 24. When removing a soiled gown from a client who has an IV, the BEST action is to a. remove the opposite arm from the gown first. b. have the nurse remove the IV needle. c. disconnect the bag and tubing. d. slip the gown over the IV solution bag. 25. If your client does not eat all the food on his tray, the FIRST thing you should do is a. notify the charge nurse. b. ask the client why. c. remove the tray. d. urge the client to eat all the food. 26. The client states that a mistake has been made: There is salt on her tray, although the doctor has ordered a low-salt diet. The nurse aide should a. explain this means no salt when preparing food. b. tell the client not to use the salt. c. check the diet order with the charge nurse. d. call the kitchen for a new tray. 27. The MAIN safety factor in transferring a client is to a. always transfer slowly. b. raise the side rails. c. secure adequate assistance. d. make sure the client is not tired. 28. Before transferring a client from the bed to a wheelchair, the nurse aide should sit him or her on the edge of the bed for a few minutes to a. rearrange his or her gown or clothing. b. prevent orthostatic hypotension. c. position and secure the wheelchair. d. rest and remove the transfer belt. 29. The client’s religion forbids eating meat. Beef stew is being served for lunch. The nurse aide should a. tell the client to eat it because she needs protein. b. tell the client it is all right since her doctor ordered the diet. c. ask the nurse to call the kitchen. d. tell the client that restrictions don’t pertain in times of illness. 30. It is important to remember that dying patients a. have the same needs for care as other patients. b. need to be by themselves in a quiet room. c. do not need to be consulted regarding their care. d. are usually in pain. 31. Dying patients and their families a. always pass through five stages of dying in order. b. always accept death before it occurs. c. may go back and forth among the five stages. d. must go through all stages of dying before they die. 32. A sign of dementia in elderly clients is a. a need to eat regular meals. b. not knowing who and where they are. c. an ability to figure out problems. d. a good memory for recent events. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2– 4833. Clients with Alzheimer’s disease may show which of the following signs/symptoms? a. physical and mental wasting away b. extremely clear memory c. frequent pacing or wandering d. a and c only 34. When a client turns on the call light every few minutes, the appropriate response is to a. ask the client not to call so often. b. stop by the room more often. c. place the call light out of reach. d. tell the client how busy you are. 35. Many older adults suffer loss of a. income. b. physical strength. c. loved ones. d. all of the above 36. How a client reacts to illness and disability is MOST dependent on his or her a. age and stage of life. b. spouse’s support. c. income and level of education. d. support system and life history. 37. An 85-year-old client tells you that his mother is coming to visit. Your BEST response would be a. “That’s impossible. Your mother can’t come to see you.” b. “That’s nice, when is she coming?” c. “Tell me how old your mother is.” d. “Are you wishing you could see your mother?” 38. A client hits you during lunch. The appropriate response is to a. call the charge nurse for help. b. continue to feed her. c. apply a restraint. d. yell at her to stop hitting you. 39. The nurse aide must report abuse of a client by a. the family. b. the staff. c. another client. d. all of the above 40. If the client is in traction, the nurse aide should never a. monitor affected skin temperature. b. give a total bed bath. c. change the position of weights. d. monitor distal pulses. 41. Security for a client’s dentures includes a. keeping them in a tissue in a dresser drawer. b. placing them in a labeled denture cup. c. insisting the resident wear the dentures. d. placing an identifying mark on the dentures. 42. If family members bring new clothes in for an ECF resident, the nurse aide should a. put them in the resident’s dresser drawers. b. label them with the resident’s name. c. ask the family to remove an equal number of old clothes. d. make sure the charge nurse sees the clothes. 43. The charge nurse instructs you to clean an ECF resident’s closet. You should a. throw away all torn clothes. b. ask the family to come do it. c. enlist the help of the resident. d. tell the nurse you are too busy. 44. Before dressing an ECF resident, the nurse aide should a. close the door and pull the curtain. b. choose the proper clothes. c. check for a doctor’s order. d. all of the above –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2– 4945. Confidentiality refers to a. never sharing information with anyone. b. the right of the patient to privacy. c. only sharing information with those involved in the client’s care. d. both b and c 46. As a nurse aide, it is your responsibility to a. plan the client’s care. b. do the tasks the supervisor assigns to you. c. do the best you can without asking for help. d. compare assignments with your coworkers. 47. Maintaining good interpersonal relationships depends on a. going along with the crowd. b. communicating clearly with others. c. following orders without questioning. d. all of the above 48. If you do not know how to do an assigned task, you should a. call another nursing assistant for help. b. ask the client how she prefers to have it done. c. call the charge nurse and ask for help. d. follow the instructions in the procedure manual. 49. Reporting exactly what you see is an example of a (an) observation. a. clinical b. objective c. personal d. subjective 50. The purpose of using restraints is to a. position an atrophied extremity. b. protect the client and others from injury. c. prevent wandering in the halls. d. all of the above 51. Failure to raise the side rails on the bed of a confused client is an act of a. malpractice. b. negligence. c. overt commission. d. breaking a criminal law. 52. During a job interview, it is important to tell the interviewer about your a. scheduling needs. b. childcare needs. c. qualifications. d. all of the above 53. When you are unable to work due to illness, you should a. arrange for someone to cover for you. b. call the facility as early as possible. c. call your charge nurse an hour before your scheduled time. d. notify the facility at least 30 minutes before your scheduled time. 54. The primary reason for laundering a nursing uniform after each day’s wearing is to a. look professional. b. look neat. c. remove body odor. d. prevent the spread of germs. 55. The client asks to see a priest. The nurse aide should a. ask the charge nurse to call a priest. b. tell the client to see if a priest walks by his or her door. c. call the doctor. d. tell the client to call herself. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2– 5056. When caring for a client who has just been placed on NPO, the nurse aide should first a. encourage the client not to think about food and water. b. encourage the client to eat and drink. c. remove the water pitcher and all items of food and drink. d. give the client meticulous mouth care. 57. A client states that his wallet is lost. The FIRST action of the nurse aide would be to a. help to look for it. b. notify the doctor. c. ask all of the other clients if they have seen it. d. notify the charge nurse. 58. Which statement about mouth care for unconscious residents is correct? a. Unconscious residents may be able to hear you speaking to them during mouth care. b. Unconscious residents can both swallow and spit. c. Unconscious residents do not need to be observed for mouth sores. d. Unconscious residents have very moist gum tissue. 59. A client is hearing impaired. The client has the right to a. written notes. b. a professional interpreter. c. assistance with hearing aids. d. all of the above 60. A coworker states that she will need help in lifting a heavy client. The nurse aide should a. offer to get a Hoyer lift. b. locate additional coworkers. c. state that she has back trouble. d. a and b –CHAPTER TITLE– 51 –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2–Pretest 1. d. Any patient who is bed bound may develop a decubitus ulcer. Those who also are incontinent, paralyzed, or poorly nourished will develop ulcers more rapidly. 2. a. A resident must be able to support some weight before using a walker. 3. b. If the cane is not used on the strong side, the resident may fall. 4. c. Active ROM means the resident moves his or her own limbs. 5. b. Choice a is incorrect because it is impossible to move the walker and the feet at the same time. Choices c and d are incorrect because you should encourage clients not to slide their feet or the walker. 6. d. Correctly positioning a patient should prevent skin breakdown, increase comfort, and maintain the function of joints and muscles. 7. c. Choice c is the only answer that addresses resident privacy, modesty, and personal choice. 8. c. Turning the resident is the easiest method, and it is important to hold the pan to prevent spilling the contents. 9. d. The correct answer is obtained by subtracting the amount of fluid left from the fluid amount the resident started with. 10. b. Always bring such complaints to the charge nurse. Exam 2 1. a. Take care of spills immediately, or a patient may be injured while waiting for housekeeping. 2. a. Always call for help first in an emergency. 3. d. When making an occupied bed, it is important to make half of the bed at one time, to have one side rail up and one down, and to make a toe pleat in the top covers. 4. d. While choices a and b are correct, there is no data to suggest that choice c is correct. 5. c. Always make sure the resident is allowed to get up first. 6. c. Only respirations are out of normal range. 7. d. All three answers are correct. 8. b. Systolic is always marked as the first clear sound. 9. b. The abbreviation q.o.d. means every other day. 10. c. Infection control (hand washing) is always the first step in a procedure. 11. c. Only sterilizing destroys bacteria. 12. c. Always remove the resident from danger first. 13. d. Choice a is wrong because the flow is set by the physician. Choice b is wrong because wool can cause sparks, and c is wrong because alcohol causes drying. Therefore, only choice d is correct. 14. a. The patient must be flat on a hard surface or the compressions will be inadequate to circulate blood. 15. a. A procedure manual is a written set of instructions on how to perform procedures. –CHAPTER TITLE– 52 Answers and Explanations –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2–16. b. It is mandatory to provide a certified interpreter to clients not fluent in English. 17. b. Only an identification band is a sure thing. A confused patient may answer to any name. 18. c. All residents need nail care. The nursing assistant should be able to obtain information needed from the care plan. 19. b. Material may build up under the foreskin in uncircumcised males unless the foreskin is retracted for cleaning. 20. d. A correctly given backrub improves circulation, thus relaxing the patient while giving you an opportunity for one-on-one interaction. 21. a. There may be many reasons for dry skin, including medication reactions. The charge nurse should see the problem before any lotion is applied. 22. d. Choices a, b, and c are all common causes of decubitus ulcers. 23. d. Choices a, b, and c are all expected outcomes of a shampoo. Therefore, d is the best answer. 24. a. Remove the sleeve from the arm without tubing first. 25. b. The patient may not be eating due to personal dislike of the food. Asking first allows you to request a replacement if the problem is this simple. 26. c. Any diet question must be answered before the resident eats. 27. c. Transferring safely means planning ahead, including obtaining help. 28. b. Orthostatic hypotension is the light-headed feeling we all get when we rise too fast. 29. c. The other answers do not address the resident’s right to practice religion or her right to choice. 30. a. Not all dying patients have the same problems, but they have all the same care needs as anyone else. 31. c. Because each dying resident has unique emotional needs, each person will go through the stages at different times and in different order. 32. b. Only choice b is usually seen in dementia. 33. d. Physical and mental wasting away are common symptoms of Alzheimer’s disease, as is frequent pacing or wandering and loss of memory. 34. b. Patients who use their call bell frequently are usually afraid they will be ignored if they don’t call often. Stopping in frequently reassures them. 35. d. As people age, many suffer loss of income (retirement usually means a fixed income), physical strength, and loved ones. 36. d. A person’s total environment always affects everything that person does and thinks. 37. d. “Are you wishing you could see your mother?” is the only response that uses therapeutic communication skills. 38. a. Obtaining assistance is the only correct way to deal with abuse by a resident. 39. d. Federal and state laws require reporting of any abuse, whether it comes from staff, family, or other residents. 40. c. Position of weights in traction is ordered by a doctor. Therefore, the nursing assistant should never change the position of weights without an order. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2– 5341. b. Every resident with dentures must have a labeled denture cup to ensure security of the costly dentures. 42. b. All residents have the right to their own personal possessions. Labels allow you to better provide protection. 43. c. The resident has the legal right to decide on keeping or throwing away personal belongings. 44. a. Choice b is incorrect because some residents are capable of choosing their own clothing. Choice c is incorrect because there will not be a doctor’s order for dressing. Choice d is therefore also incorrect. 45. d. Choice a is incorrect because important patient information would be missed if you never shared information with anyone. Choice d is the correct answer because both b and c are true. 46. b. Choice a is incorrect because you are a member of the planning team, not the major planner. Choice c is incorrect because in healthcare the correct action is often to ask for help. Choice d is incorrect because there is no legitimate reason to compare notes with coworkers. 47. b. Choices a and c are both incorrect as they may lead to poor patient care. Choice d is wrong if both a and c are wrong. 48. c. Asking for help when you are unsure of yourself is a critical element of employability skills. 49. b. Objective means something you can see, feel, smell, or touch. 50. b. According to federal law, protection from injury to self or others is the only acceptable reason for using restraints. 51. b. Negligence is an unintentional act of injury. 52. c. A job interview is the time to sell yourself, so tell the interviewer your qualifications. You should not discuss childcare or scheduling needs until after you are offered the job. 53. b. Each shift you work may have a different time requirement. 54. d. Preventing the spread of germs is the principal reason for all infection-control measures. 55. a. It is a client’s right to have clergy available as requested. 56. c. NPO means nothing by mouth, so removing all food and water will reduce temptations. 57. d. The first step for any lost belongings is always to notify the charge nurse. 58. a. The last sense to leave is hearing. Speak with kindness and be aware of what you say. 59. d. Mandates are in place to help the hearing impaired in communication. 60. d. It is necessary to work as a team for the safety and well-being of staff as well as clients. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2– 54YO U A R E N OW practice test-taking experience will help you most, however, if you have created a situation as close as possible to the real one. In this test, you will notice that the short, ten-question pretest is not sep- beginning to be very familiar with the format of the nursing assistant exam. Your arated out like it was in the first two practice exams, but rather these questions are incorporated into the test to reproduce, even more closely, official test-taking conditions. For this third exam, simulate taking the real test. Find a quiet place where you will not be disturbed. Have with you sharpened pencils and a good eraser. Complete the test in one sitting, setting a timer or a stopwatch. You should have plenty of time to answer all of the questions when you take the real exam, but you want to work quickly without rushing. As before, the answer sheet you should use is on the next page. Following the exam is an answer key, with all the answers explained. These explanations will help you see where you need to concentrate further study. Once you have reviewed the answer explanations and referred to the question-type breakdown in Appendix A, you will know which parts of your training materials you need to concentrate on before you take the fourth exam. C H A P T E R Nursing Assistant/Nurse Aide Practice Exam 3 CHAPTER SUMMARY This is the third of five practice exams in this book based on the National Nurse Aide Assessment Program (NNAAP) written exam. Use this test to identify which types of questions are still giving you problems. 5 55–NURSING ASSISTANT/NURSE AIDE ANSWER SHEET– 57 Exam 3 1. a b c d 2. a b c d 3. a b c d 4. a b c d 5. a b c d 6. a b c d 7. a b c d 8. a b c d 9. a b c d 10. a b c d 11. a b c d 12. a b c d 13. a b c d 14. a b c d 15. a b c d 16. a b c d 17. a b c d 18. a b c d 19. a b c d 20. a b c d 21. a b c d 22. a b c d 23. a b c d 24. a b c d 25. a b c d 26. a b c d 27. a b c d 28. a b c d 29. a b c d 30. a b c d 31. a b c d 32. a b c d 33. a b c d 34. a b c d 35. a b c d 36. a b c d 37. a b c d 38. a b c d 39. a b c d 40. a b c d 41. a b c d 42. a b c d 43. a b c d 44. a b c d 45. a b c d 46. a b c d 47. a b c d 48. a b c d 49. a b c d 50. a b c d 51. a b c d 52. a b c d 53. a b c d 54. a b c d 55. a b c d 56. a b c d 57. a b c d 58. a b c d 59. a b c d 60. a b c d 61. a b c d 62. a b c d 63. a b c d 64. a b c d 65. a b c d 66. a b c d 67. a b c d 68. a b c d 69. a b c d 70. a b c d Exam 3 1. Inactivity and immobility may cause all of the following EXCEPT for a. skin breakdown. b. permanent contractures. c. increased intestinal peristalsis. d. secretions remaining in the lungs. 2. The nurse aide knows that the term “up ad lib” means the client a. is not permitted out of bed. b. is independent with balanced periods of rest and activity. c. is out of bed at mealtime only. d. will need assistance of two for all activities of daily living. 3. Mr. Perez is very weak and uncoordinated from a previous stroke. The nurse aide selects which device to assist Mr. Perez in walking safely? a. geri-chair b. transfer belt c. trochanter roll d. Hoyer lift 4. A common sign of approaching death is a. increased appetite. b. normal or elevated vital signs. c. severe, unceasing pain. d. decreased body functions. 5. The BEST definition of the range-of-motion term abduction is to a. bring a body part to a center or middle line. b. bend the sole of the foot. c. overextend a limb or part. d. move a body part away from a center or middle line. 6. You notice that Mrs. Small’s vital signs are decreasing and her respirations are zero. You SHOULD a. continue with her normal care. b. wait five minutes and take her vital signs again. c. tell the family that she is dead. d. contact the charge nurse immediately. 7. After Mrs. Small’s death, her husband wishes to share his feelings and emotions. The nurse aide SHOULD a. listen and try to comfort him. b. change the subject. c. tell him to go to a counselor. d. tell him to keep his feelings to himself. 8. An example of a special device to help prevent contractures is a (an) a. handroll. b. doppler. c. air mattress. d. manometer. 9. Saying that a coworker took a client’s money when this is UNTRUE is an example of a. negligence. b. assault. c. defamation. d. hoarding. 10. Paraplegia refers to paralysis of the a. legs or lower part of the body. b. the left half of the body. c. all four extremities. d. arms or upper part of the body. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 5911. The MOST accurate method of measuring body temperature is a. rectal. b. oral. c. axial. d. feeling the forehead. 12. Which of the following sets of vital signs should be reported IMMEDIATELY? a. T–98.6, P–60, R–14, BP–120/60 b. T–102.4, P–100, R–32, BP–180/100 c. T–99.6, P–80, R–16, BP–132/70 d. T–97.6, P–82, R–20, BP–110/60 13. A large glass holds 240 cc. The patient drank one-third of the large glass. The nurse aide would record this as a. 13 of 240 cc. b. 30 cc. c. 80 cc. d. 120 cc. 14. Mr. Jones is placed on strict intake and output after surgery. The nurse aide SHOULD a. keep Mr. Jones NPO. b. record all of the solid foods Mr. Jones eats. c. record all fluid intake and output every shift. d. measure only the first voiding after surgery. 15. Which of the following would be included in a client’s output record? a. urine, food eaten, and IV solutions b. urine, emesis, and bleeding c. liquids taken in during the shift d. bowel movements only 16. Which of the following is an intake-and-output problem that the nurse aide MUST report? a. The client states that he is not hungry. b. The client requests a bedpan. c. The client has not voided in eight hours. d. The client’s eight-hour output is 600 cc. 17. Mrs. Brown’s water pitcher holds 600 cc. The pitcher is full at the beginning of the shift. Halfway through the shift, the pitcher is empty, and you refill it. At the end of the shift, the pitcher is one-half full. Total water intake for the shift is a. 1,200 cc. b. 600 cc. c. 900 cc. d. 300 cc. 18. The nurse aide finds a damaged piece of equipment. The nurse aide SHOULD a. dispose of it immediately. b. use it until new equipment arrives. c. report it immediately. d. repair it herself and then use it. 19. The nurse aide shouts at Mr. Moore for climbing out of bed. This behavior is not acceptable and is considered to be a. verbal abuse. b. neglect. c. physical abuse. d. none of the above 20. The nurse aide finds ants in the client’s room. The nurse aide SHOULD a. ask the client to wear slippers in the room. b. contact housekeeping immediately. c. ask the client not to eat in the room. d. place ant traps around the room. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 6021. When restraints are in use, the nurse aide SHOULD report a. the type of device being used. b. the time the restraint was released. c. any unusual observations about the patient’s skin condition. d. all of the above 22. The pulse located in the neck is called the a. apical pulse. b. femoral pulse. c. radial pulse. d. carotid pulse. 23. Mrs. Wilson complains of numbness on one side of her body. You notice that her grip is weak and her speech is slurred. You SHOULD a. realize that this may be a sign of a CVA and notify the charge nurse. b. call the doctor and tell him Mrs. Wilson had a CVA. c. check to see if Mrs. Wilson’s condition is the same the next day. d. accept the condition as normal and reassure Mrs. Wilson. 24. Common signs and symptoms of a urinary tract infection may include a. extreme thirst and hunger. b. lack of appetite and stomach pain. c. constipation alternating with diarrhea. d. frequent urination with burning sensation. 25. The order “vital signs q.i.d.” means to record vital signs a. four times per day. b. twice per day. c. morning and evening. d. once per shift. 26. The nurse aide notices that Mrs. Nix has an open red area on her coccyx that is draining. The nurse aide SHOULD a. wash the area with soap and water and apply alcohol. b. ask another nursing assistant to look at it and give her opinion. c. check it again at the same time the next day. d. tell the charge nurse so she can check it. 27. While you are walking Mrs. Grey in the hallway, she complains of chest pain and dizziness. Your FIRST response should be to a. sit her on the floor and go get help. b. call for help immediately but stay with her. c. continue the walk so as not to alarm her. d. tell her to relax because everything will be okay. 28. Mr. Smith has just smoked a cigarette. It is time to take his temperature. The nurse aide SHOULD a. wait 15–20 minutes and then take an oral temperature. b. take an oral temperature immediately. c. give him some cold water to counter the effect of smoking and then take an oral temperature. d. take a rectal temperature to discourage him from smoking. 29. Which of the following observations should be reported IMMEDIATELY? a. T–98.2, P–88, R–20 b. yellow-colored urine c. bluish tint to lips and skin d. skin that is warm and dry to the touch –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 6130. Microorganisms can be spread by direct and indirect contact. An example of indirect contact is a. bathing the patient. b. using contaminated blood. c. touching objects or dirty instruments. d. breathing dust particles in the air. 31. Which statement about the hand-washing procedure is CORRECT? a. The faucet is clean and may be touched during hand washing. b. Wash at least two inches above the wrist. c. As long as soap is used, the temperature of the water doesn’t matter. d. All of the above are correct. 32. The call light in the shower comes on. As you enter the shower, you find Mrs. Shepard lying on the floor. You should IMMEDIATELY a. run back to the nurses’ station to get help. b. help her to a chair, and then resume her shower. c. shake her gently and shout “Are you okay?” d. scold her for not asking for assistance with her shower. 33. Which statement about use of fire extinguishers is CORRECT? a. Any fire extinguisher can be used on any fire. b. Each extinguisher should be used for the correct type of fire. c. Nurse aides are not responsible for using fire extinguishers. d. Fire extinguishers should not be used around patients. 34. As you feed Mrs. Sanford, she begins to choke. Mrs. Sanford is conscious, but she is unable to speak or cough. The nurse aide SHOULD a. administer abdominal thrusts. b. look in her mouth to see what she is choking on. c. get the doctor at once. d. keep feeding her to push the food down. 35. The nurse aide SHOULD tell the licensed nurse if a patient with does not finish the food on his tray. a. stroke b. cancer c. diabetes d. Alzheimer’s disease 36. Techniques to keep the client’s skin clean and healthy include a. using prescription soaps only. b. using clear water but no soap. c. rinsing the skin well after soaping. d. using a lot of suds. 37. Giving good oral care to a client includes all of the following EXCEPT a. wearing gloves. b. handling and storing dentures carefully. c. using dental floss. d. removing oxygen before brushing. 38. To prevent infection in a client with an indwelling catheter, the nurse aide SHOULD a. keep the drainage bag higher than the bladder. b. do perineal care from front to back as needed. c. let the tubing make a U loop below the bed. d. do perineal care every other night. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 6239. Mr. Spear is on a full liquid diet. You would expect to find which of the following food items on his breakfast tray? a. oatmeal, juice, and coffee b. pureed eggs and toast c. clear broth, gelatin, and milk d. pancakes, bacon, and tea 40. Which statement about injuries to clients and staff members is CORRECT? a. Injuries should be treated and reported on an incident report. b. Injuries can be ignored if they are minor. c. Injuries should be reported only if they are major. d. Injuries should be treated but do not need to be reported. 41. Which statement about horseplay and practical jokes is CORRECT? a. They are permitted if no one is insulted. b. They are acceptable during breaks. c. They can cause accidents and are unacceptable. d. They are allowed because they cheer up the patients. 42. The nurse aide used an electric razor to shave Mr. Bailey and nicked him on the chin. The nurse aide SHOULD a. ignore the nick and continue. b. call the doctor. c. report the nick to the licensed nurse. d. put alcohol on the nick. 43. Nonverbal communication includes a. talking to the client. b. observing the client’s body language. c. asking the client if she is in pain. d. speaking to the client quietly. 44. When clients are in a healthcare institution, they expect to be treated as stated in the a. Infection Control Manual. b. Patient’s Bill of Rights. c. Policy and Procedure Manual. d. Physician’s Code of Ethics. 45. A conversation about a client in the hospital’s elevator is against the a. client’s right to privacy. b. client’s right to medical care. c. client’s right to review their records. d. client’s right to ask questions. 46. Several members of the healthcare team have received verbal sexual comments from Mr. Harris, a client on the unit. In discussing this problem at a staff meeting, the team decides the MOST appropriate response would be a. “You are making me blush, Mr. Harris.” b. “Mr. Harris, your comments are not acceptable to me.” c. “You really have a great sense of humor, Mr. Harris.” d. “Mr. Harris, you really should be ashamed of yourself!” 47. Which one of your five senses would BEST detect Joan Dillon’s body rash? a. sight b. smell c. touch d. hearing –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 6348. The BEST way a nurse aide can clean an infant’s eyes is with a (an) a. Q-tip swab lubricated with Vaseline. b. moist cotton ball, wiping from the inner to the outer corner. c. alcohol wipe, using circular motions. d. hot towel, wiping from the outer to the inner corner. 49. Mrs. Enbody is hard of hearing and repeatedly turns her call light on. When responding to her call light, the nurse aide SHOULD a. take time to listen to her to determine her needs. b. talk loudly to her since she is hard of hearing. c. unplug the call light. d. tell the charge nurse that Mrs. Enbody is uncooperative. 50. Mrs. Jones states, “I’m not nervous about this surgery,” but she is restless and unable to get comfortable. The nurse aide SHOULD a. recognize that Mrs. Jones’s body movements indicate fear and ask the nurse to speak with her. b. pad the side rails on the bed to prevent an accident. c. ask Mrs. Jones’s family members to leave so she will be able to settle down. d. tell her everyone is nervous about surgery and that she should relax. 51. Which member of the healthcare team is responsible for the client’s discharge plan? a. nurse aide b. ward/unit clerk c. registered nurse d. dietician 52. A two-month-old infant has been crying continuously. The nurse aide SHOULD a. check the baby’s diaper. b. see if it is time for a feeding. c. cuddle or rock the baby. d. all of the above 53. Mrs. Beck’s husband refuses to leave the room in which you are bathing her. You SHOULD a. insist that he leave. b. allow him to help you. c. refuse to bathe Mrs. Beck. d. say “Fine, do it yourself,” and leave. 54. While providing personal care for a client, the nurse aide SHOULD a. uncover the client completely so he or she can work quickly. b. uncover only the area he or she is working on. c. keep the client completely covered and work under the covers. d. leave the curtain open at all times. 55. When providing morning (A.M.) care for the client, the nurse aide SHOULD a. let the client do as much as he is able to. b. do everything for the client so it is done correctly. c. care only for clients who are the same sex. d. work as quickly as possible. 56. After Mr. Hall’s stroke, his right arm is weak and stiff. He SHOULD be taught to a. put his right arm into his shirt first. b. put his left arm into his shirt first. c. put both arms in the shirt at the same time. d. wear a gown to make dressing easier. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 6457. Dressing will be difficult for a client who a. has a contracted arm. b. is left-handed. c. has impaired speech. d. is elderly. 58. If a client objects to certain food for religious or cultural reasons, the nurse aide SHOULD a. tell him to grow up and eat like an adult. b. offer to get something different for him. c. tell him he will have to speak to the dietician tomorrow. d. tell him he will be given a tube feeding if he won’t eat. 59. Bill, a terminally ill resident, refuses his bath and throws the water basin across the room. He is in what stage of dying? a. denial b. bargaining c. acceptance d. anger 60. Mrs. Jones begs, “Just let me live until my grandchild is born.” She is in what stage of dying? a. acceptance b. anger c. bargaining d. denial 61. An important thing the nurse aide can do for a dying client is to a. leave him alone to allow for privacy. b. give physical and emotional support. c. encourage him to believe that a miracle may occur. d. force him to eat three meals a day to keep up his strength. 62. What is MOST important to show the client in his new room? a. the television remote control b. how to lower and raise the bed c. the location of the call bell and how to use it d. where to store personal belongings 63. The older adult likes to feel positive about himor herself by sharing past achievements and experiences. The BEST way the nurse aide can encourage this is by a. pairing the older adult with another talkative resident. b. encouraging frequent rest periods to save energy for socializing. c. listening to the older adult’s past experiences. d. telling the older adult that you are too busy to listen to stories. 64. In caring for the client with anxiety, the nurse aide SHOULD a. remain calm. b. use simple, easy-to-understand words. c. provide a quiet atmosphere. d. all of the above 65. A client asks the nurse aide if she could have a few minutes to pray before her bath. The BEST response by the nurse aide would be to a. tell her that her bath comes first. b. allow her some private time to pray. c. tell her to wait until clergy visits. d. ignore her request and start bathing her. –CHAPTER TITLE– 65 –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3–66. During orientation of your new job, you realize your shift ends at 3:30 P.M. and not at 3:00 P.M. as you had thought. Your child needs to be picked up every day by 3:15 P.M. You SHOULD a. discuss this with the charge nurse as soon as possible. b. ask the other nurse aide to cover you for fifteen minutes. c. leave early and hope no one notices your absence. d. come in 15 minutes earlier in the morning. 67. The BEST definition of a certified nursing assistant is a a. graduate nurse who is registered and licensed by the state to practice nursing. b. licensed person who provides education about special diets. c. person who transcribes the physician’s orders for patient care. d. person who is certified to give care under the direct supervision of a registered or licensed practical nurse. 68. When the nurse aide shows genuine interest and concern for the client, this is an example of a. honesty. b. caring. c. teamwork. d. accuracy. 69. When you are giving a bedbath to a client, you SHOULD a. put the bed in the low position. b. cover the resident with a bath blanket. c. wash the perineal area from back to front. d. put the dirty towels and linen on the floor. 70. An indwelling catheter drains the bladder of a. feces b. emesis c. urine d. blood –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 66Exam 3 1. c. Intestinal peristalsis decreases with inactivity and immobility. 2. b. “Up ad lib” is an activity order suggesting the client can perform ADLs independently with periods of rest as needed. 3. b. A transfer belt (also called safety, ambulation belt) is used by caregivers to assist the client to transfer or walk safely. 4. d. As circulation slows, body functions decrease. 5. d. Abduction refers to the movement of a body part away from a center or middle line. 6. d. Lack of respiration and low vital signs may signify approaching death. Report this immediately. 7. a. Caring for the family is just as important as caring for the client. Allow the husband to vent his feelings. 8. a. A handroll is placed in the palm of the hand to prevent the hand and fingers from contracting in the flexed position. 9. c. Defamation is harming a person’s reputation by words that you say (slander) or write (libel) intentionally. 10. a. Paraplegia is paralysis of the leg or lower part of the body. 11. a. The rectal temperature method is considered the most accurate as the thermometer is in direct contact with membranes. 12. b. A temperature of 102.4 is elevated. The patient’s pulse indicates tachycardia. The patient also has hypertension. 13. c. One-third of 240 equals 80. 14. c. Any fluid taken in or released from the body is considered when the patient is on I and O. 15. b. Urine, emesis, and bleeding are all considered output. 16. c. Failure to void (urinate) may indicate kidney failure. 17. c. 600 cc + 300 cc (half of the pitcher) is the total, or 900 cc. 18. c. Reporting damage to equipment immediately will prevent an accident. 19. a. Verbal abuse such as shouting or name calling is not professional behavior and violates the client’s rights. 20. b. Insects carry diseases and should not be found in the health care setting. 21. d. All checks are necessary to prevent accidents from occurring. 22. d. The carotid pulse is located in the neck. 23. a. The nurse aide must be familiar with unusual signs and symptoms and report them as soon as possible. 24. d. Both signs and symptoms are due to the infectious process. 25. a. “Q.i.d.” means four times per day. 26. d. An opening in the skin predisposes the client to infection and must be checked by the nurse. 27. b. Never leave a patient alone in the time of an emergency. Get help immediately. 28. a. Smoking may cause a misreading of the client’s body temperature. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 67 Answers and Explanations29. c. Blush discoloration (cyanosis) indicates a low oxygen level in the body. The condition can be life threatening. 30. c. Objects such as bed linens, dishes, and dirty instruments harbor microorganisms. 31. b. Washing above the wrist is part of the correct hand-washing procedure. 32. c. Shake and shout to determine if the client is oriented and/or conscious. 33. b. Different extinguishers are used on various types of fires. 34. a. The abdominal thrust will dislodge the food. 35. c. A diabetic’s blood sugar is controlled by diet and medication. Any food not eaten will affect the blood sugar level. 36. c. Rinsing the soap off thoroughly helps prevent drying of the skin. 37. d. Oxygen does not interfere with oral hygiene. 38. b. Always wipe from front to back to prevent rectal germs from entering the vagina or urinary tract. 39. c. Any liquids are considered to be part of a fullliquid diet, including milk products. 40. a. Minor and major injuries must be documented. 41. c. The role of the caregiver is to act professionally and focus on the client care. 42. c. Any body scratches, lacerations, or cuts must be reported immediately. 43. c. Body language includes posture, gestures, and facial expressions that a person uses in communicating with others. 44. b. Patient’s Bill of Rights is a written statement that includes the rights clients are entitled to when receiving healthcare. 45. a. Conversations regarding a client should never take place in a public area such as an elevator. This violates the client’s right to privacy. 46. b. Sexual comments by a client are inappropriate. The health worker must let the client know that the comments are unacceptable. 47. a. Skin rashes are observed by inspecting the body daily. 48. b. Infant’s eyes are cleaned from inner to outer to prevent the spread of infection. A moist cotton ball is soft and will not injure the eye. 49. a. Listening carefully to the patient’s needs encourages communication and builds trust. 50. a. Nonverbal communication such as body movement indicates the client’s anxiety. 51. c. The registered nurse is the team member listed who is responsible for the discharge. 52. d. Crying indicates the infant needs attention. Check or do all of the above. 53. b. Encourage family members to be involved in all aspects of care. 54. b. Covering the areas you are not working on will allow privacy and keep the body warm. 55. a. Encouraging independence allows clients to feel self-worth by participating in their own care. 56. a. Always put the affected limb into the clothing first to prevent injury to the limb. 57. a. The contracted arm limits the range of motion. 58. b. Consideration of cultural or religious beliefs is important to all clients. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 6859. d. Talking to Bill will allow him to express anger appropriately. 60. c. The stages of death vary from client to client as death occurs. Assist Mary in expressing her concerns. 61. b. All aspects of care are vital to terminal clients. 62. c. Providing a means to call a nurse is important to avoid injury and meet the client’s needs. 63. c. Listening tells the clients you are interested in what they have to say. 64. d. Remain calm, using simple and easy words to understand, and providing a quiet atmosphere are all conducive to caring for a client with anxiety. 65. b. Respecting a client’s spiritual needs is an important aspect of the client’s care. 66. a. Being honest and up-front with your supervisor is the best approach. 67. d. This is the only correct definition of a certified nursing assistant. The nurse assistant is always under the direct supervision of a licensed nurse. 68. b. Nursing is caring. It is an attitude of interest and concern. 69. b. Privacy and warmth are in accordance with the client’s Bill of Rights. 70. c. A catheter inserted in the bladder drains urine from the body. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3– 69TH I S I S T H E exam in this book. It is not any harder than the other three have been. It is simply another repre- sentation of what you might expect for the real test. Just like in the third practice test, the pretest ques- second-to-the-last sample National Nurse Aide Assessment Program (NNAAP) written tions have been integrated into the test. Just as when you go to take the real test, there shouldn’t be anything here to surprise you. That’s the idea for the real test, too—that you won’t be surprised, so you won’t be unprepared. C H A P T E R Nursing Assistant/Nurse Aide Practice Exam 4 CHAPTER SUMMARY This is the fourth of five practice exams in this book based on the National Nurse Aide Assessment Program (NNAAP) written exam. Use this test and the question breakdown in Appendix A to identify which types of questions are still giving you problems. 6 71–NURSING ASSISTANT/NURSE AIDE ANSWER SHEET– 73 Exam 4 1. a b c d 2. a b c d 3. a b c d 4. a b c d 5. a b c d 6. a b c d 7. a b c d 8. a b c d 9. a b c d 10. a b c d 11. a b c d 12. a b c d 13. a b c d 14. a b c d 15. a b c d 16. a b c d 17. a b c d 18. a b c d 19. a b c d 20. a b c d 21. a b c d 22. a b c d 23. a b c d 24. a b c d 25. a b c d 26. a b c d 27. a b c d 28. a b c d 29. a b c d 30. a b c d 31. a b c d 32. a b c d 33. a b c d 34. a b c d 35. a b c d 36. a b c d 37. a b c d 38. a b c d 39. a b c d 40. a b c d 41. a b c d 42. a b c d 43. a b c d 44. a b c d 45. a b c d 46. a b c d 47. a b c d 48. a b c d 49. a b c d 50. a b c d 51. a b c d 52. a b c d 53. a b c d 54. a b c d 55. a b c d 56. a b c d 57. a b c d 58. a b c d 59. a b c d 60. a b c d 61. a b c d 62. a b c d 63. a b c d 64. a b c d 65. a b c d 66. a b c d 67. a b c d 68. a b c d 69. a b c d 70. a b c d Exam 4 1. When assisting a blind client to eat, the nurse aide SHOULD a. set the plate as a clock with food at 1:00, 5:00, 8:00, and 11:00. b. set the plate as a clock with food at 12:00, 3:00, 6:00, and 9:00. c. give him the plate and tell him where the food is. d. feed him herself to save time. 2. Lena, a 70-year-old resident, wishes to write out her own Christmas cards. The nurse aide SHOULD a. call her daughter to do it for her. b. provide her with supplies and an appropriate working space. c. let her manage it entirely by herself. d. write the Christmas cards out for her. 3. A cane SHOULD be used on a. the affected side. b. the unaffected side. c. either side, depending on how the client feels. d. the weak side one day and the strong side the next. 4. The client who is at high risk of developing a pressure sore is one who a. eats poorly. b. moves herself often. c. has an unwrinkled bed. d. has Alzheimer’s disease. 5. Which of the following helps prevent decubitus ulcers? a. bed rest b. liquid diet c. back rubs d. support hose 6. The nurse aide, a member of the healthcare team, can participate in the nursing process EXCEPT for a. collecting data. b. planning the care. c. making observations. d. carrying out selected interventions. 7. When using crutches, the client’s weight MUST rest on the a. armpit. b. knees. c. hand rests. d. shoulders. 8. How often should a client be repositioned if he cannot move himself? a. every hour b. every two hours c. every three hours d. every four hours 9. Correct range of motion for the neck includes a. flexion, extension, hypertension, and rotation. b. abduction, adduction, flexion, and extension. c. rotation, abduction, adduction, and extension. d. pronation, supination, and flexion. 10. The goal of bladder training is to a. stop using a catheter. b. gain voluntary control of urination. c. prevent skin problems caused by incontinence. d. all of the above 11. Mr. Scranton sometimes chokes while he is eating. The nurse aide SHOULD a. stay close by while he is eating. b. instruct his roommate to watch him eat. c. feed him to prevent problems. d. use the Heimlich maneuver between bites. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4– 7512. If a client complains of a burning, tingling area on his skin, you should FIRST a. rub the area well with lotion. b. report the complaint to the licensed nurse. c. keep an eye on the area for a few days. d. use cornstarch on the area. 13. When changing a pillowcase, you should NOT hold the pillow under your chin because this would a. tear the pillowcase. b. drop the pillowcase. c. dampen the pillowcase. d. spread bacteria. 14. A nonsterile dressing is one that is a. wet b. dry c. clean d. new 15. If you are asked to clean or put a soak on a resident’s eye, you SHOULD a. clean it from the inner corner to the outer edge. b. use a clean surface of the cloth each time you touch the eye. c. report any exudate. d. all of the above 16. Before giving any hot or cold treatment, the nurse aide should be sure to have a. a doctor’s order. b. a sign for the door. c. disposable equipment. d. a form to chart on. 17. Safety precautions for hot treatments SHOULD include a. leaving on the treatment for the time ordered. b. stopping the treatment if the skin is reddened. c. giving the treatment through a protective pad. d. both a and b 18. The nurse aide has been caring for Mrs. Jewell for four hours, and during that time she has asked the aide to take her to the bathroom every fifteen minutes. The nurse aide’s BEST action is to a. trade clients with another nurse aide. b. put her to bed on a waterproof underpad. c. discuss this issue with the licensed nurse. d. ignore her for a while. 19. If an elderly resident begins to wander and becomes confused, you SHOULD a. leave her in her pajamas for easier care. b. joke with her about her funny ideas. c. report her behavior for evaluation. d. tell her family she is near death. 20. The Hoyer lift is used to a. prevent injuries to healthcare workers. b. move clients who are very heavy or weak. c. move a client when only one worker is free. d. all of the above 21. When you perform passive range-of-motion exercises for a resident, you should do all the following EXCEPT a. use good body mechanics. b. move the joint until the resident feels pain. c. keep the body covered except for the joint being exercised. d. make the resident perform as much of the exercising as he can. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4– 7622. Using a broad base of support means a. keeping your feet comfortably apart. b. keeping your knees locked in place. c. holding objects away from your body. d. all of the above 23. If a client is in traction, you should NOT a. monitor affected skin temperature. b. give a complete bedbath. c. change the position of the weights. d. monitor distal pulses. 24. When the nurse aide is moving the client up in bed, the pillow goes a. on the chair, out of the way. b. at the foot of the bed, out of the way. c. at the head of the bed, to protect the head. d. anywhere the client wants it. 25. Dangling a client’s legs over the side of the bed is done to a. make sure she is able to sit up first. b. give her time to put on her shoes. c. prevent decubitus ulcers. d. prevent orthostatic hypotension. 26. Walking with a client is safest if done with a a. transfer belt. b. wheelchair a few steps behind him. c. Hoyer lift. d. nurse or doctor ready for emergencies. 27. When you have a client sit up and dangle her legs before getting up, you should watch for a. sudden paleness. b. excessive sweating. c. increased respirations. d. all of the above 28. When the nurse aide is transferring a client from the bed to the wheelchair, she should ALWAYS a. unlock the brakes on the wheelchair. b. lock the brakes on the wheelchair first. c. use a Hoyer lift. d. put socks on the client first. 29. Before any transfer, the nurse aide SHOULD a. have the nurse’s approval. b. know the proper procedure. c. use a transfer belt if needed. d. all of the above 30. The pulse located in the wrist is called the a. carotid pulse. b. apical pulse. c. femoral pulse. d. radial pulse. 31. Mr. Salzberg drinks five ounces of juice. The nurse aide would record this as a. 500 cc. b. 150 cc. c. 6 cc. d. 5 cc. 32. Which of the following sets of vital signs should be reported IMMEDIATELY? a. T–98.2 P–122 R–20 BP–84/40 b. T–99.0 P–72 R–16 BP–134/82 c. T–98.8 P–66 R–14 BP–100/62 d. T–98.6 P–90 R–18 BP–120/70 33. A piece of linen that is placed beneath the client from shoulders to thighs is called a. an underpad. b. a spread. c. a drawsheet. d. a sheet. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4– 7734. Which bedmaking procedure is used when the client remains in the bed? a. occupied bedmaking procedure b. unoccupied bedmaking procedure c. circle bedmaking procedure d. procedure using only fitted sheets 35. Which complication may happen if a post-op client does NOT take in adequate fluids? a. constipation b. blood clots c. infection d. foot drop 36. Which type of client is most likely to have problems as a result of poor nail care? a. a cancer client b. a diabetic client c. a stroke client d. a mentally retarded client 37. Mrs. Nelson has right-sided weakness. For her mouth care, the nurse aide SHOULD a. do it for her. b. pay particular attention to the left side of her mouth. c. tell her to get out the equipment and do it herself. d. let her do as much as she can and assist as needed. 38. A cane, walker, and crutches are all used to help a client walk. What else do they have in common? a. Clients must know how to use them correctly. b. They all must have rubber tips to prevent slipping. c. They all must be fitted to the client. d. all of the above 39. A resident with a paralyzed left arm may be able to feed herself if she uses a a. plate guard. b. built-up spoon. c. zipper pull. d. a and b only 40. Which statement about residents with mental retardation is generally CORRECT? a. They should be treated like children. b. They cannot walk or talk. c. They learn at a slower pace. d. They are suspicious of all teenagers. 41. A diabetic client has had her leg amputated. Her need for sexuality will a. be more important for a while. b. be less important for a while. c. disappear forever. d. be unaffected. 42. Clients with Alzheimer’s disease may show which of the following symptoms? a. high fever accompanied by chills b. clear memory of the recent and distant past c. chest pains and difficulty breathing d. physical and mental decline 43. If a client is upset and is yelling, the nurse aide SHOULD respond by a. saying sternly, “Quiet down!” b. offering to call her doctor. c. shutting her door for privacy. d. calmly sitting down with the client and listening. 44. A common sign of depression is a. attending activities daily. b. laughing and smiling. c. decreased appetite. d. socializing with friends. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4– 7845. Linda is a 35-year-old client with multiple sclerosis whose mother has always taken care of her. It would be normal for Linda to a. look to her father for care. b. refuse to see her mother. c. want to make her own decisions. d. ask her mother’s advice about everything. 46. A client who is in middle adulthood would be likely to be concerned about her a. teenage children. b. elderly parents. c. grandchildren. d. a and b only 47. A Catholic client refuses to eat meat on Fridays. Her lunch one Friday consists of a roast beef sandwich and a salad. The nurse aide SHOULD first a. tell the client to eat only the salad. b. offer to get her a meatless lunch. c. ask family members to bring in something else. d. request that a priest come and speak with her. 48. What is the BEST way you can understand cultural practices different from your own? a. Avoid giving care to clients with cultural practices different from yours. b. Try to understand other cultural practices by learning more about them. c. Eat out at different ethnic restaurants to taste various foods. d. Discuss your own beliefs and values with clients whose cultural practices are different from yours. 49. Beth is a 58-year-old permanently handicapped resident. She tends to be very quiet and to act as if nothing matters. The nurse aide can BEST show respect for her by a. telling her she is very lucky to retire so early. b. including her in her plan of care. c. serving her dinner first. d. calling her “Mom.” 50. An example of using body language while communicating is a. using gestures and facial expressions. b. writing the message on paper. c. sharing your feelings and concerns. d. offering your advice and opinions. 51. The nurse aide nods her head and smiles while she sits with Mrs. Crane. This type of nonverbal communication BEST demonstrates a. encouragement for the client to continue talking. b. displeasure at having to listen to the client. c. support for the terminally ill client. d. lack of work available for the nurse aide. 52. Mr. Jacko states, “I’m feeling really sad today.” The nurse aide responds by saying, “You are feeling sad?” This is an example of a communication technique called a. active listening. b. clarification. c. silence. d. reflection. 53. If a client asks a question about the health status of another client, the nurse aide SHOULD reply a. “That’s a good question, but I really don’t know.” b. “I cannot share that information with you.” c. “I will let you look at his chart later.” d. “Why don’t you ask him yourself?” –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4– 7954. Miss Talcott, an alert and oriented client, refuses to bathe this morning. The BEST response by the nurse aide would be a. “You are going to bathe today whether you like it or not.” b. “I don’t think your roommate will appreciate the smell in here.” c. “Can you tell me why you don’t feel like bathing today?” d. “Fine with me. I’ll get my work done earlier today.” 55. An example of false imprisonment is a. using restraints without a doctor’s order or the client’s consent. b. closing the door to the client’s room. c. treating the client differently because of their religious beliefs. d. refusing to answer a call light that rings frequently. 56. You are aware that a coworker is not providing the required care to certain residents on your floor. The nurse aide SHOULD a. keep a list of the activities not performed. b. tell all the other staff members. c. provide the care yourself. d. report this to the charge nurse as soon as possible. 57. If you are ill and cannot report to work that day, it is BEST to a. arrange for your sister to cover you. b. bring in a note when you return back to work. c. call the facility as early as possible. d. call the facility after you have seen your doctor. 58. Mrs. Larkin, age 52, was the victim of an industrial accident. She was a foreman and a union leader. To help her maintain her dignity as an adult, you might suggest that she a. read industrial magazines. b. serve on the resident council. c. rent movies. d. attend bingo. 59. A client’s daughter wants to help with her mother’s care. You should tell her that she a. cannot help. b. can only bathe her mother. c. can do whatever care she wants. d. can do whatever the nurse agrees to. 60. It is important to remember that a client in the last stage of a terminal illness SHOULD a. be left alone to grieve. b. be offered care to meet their physical and emotional needs. c. be cared for only by relatives and close friends. d. not be offered any choices about their care. 61. Dressing a resident in personal clothing every day contributes to the resident’s a. overall appearance. b. feeling of well-being. c. pulse rate. d. a and b only –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4– 8062. Mr. Collins, a 42-year-old postoperative client, has his door closed. The nurse aide needs to take a set of routine vital signs. She SHOULD a. knock on the door and wait for the client to respond. b. assume this means he does not want to be disturbed. c. open the door immediately, as doors should not be closed. d. knock and enter without waiting for a response. 63. Which of the following are listed in the Patient’s Bill of Rights? a. the right to privacy and confidentiality b. the right to make decisions about the plan of care c. the right to have a living will d. all of the above 64. Mrs. Philly insists on dressing in a striped green blouse and plaid pants. Knowing that the clothes don’t match, the nurse aide SHOULD a. insist on selecting another outfit for her. b. tell her she will look ridiculous in that outfit. c. respect her choice of clothing. d. have her remain in her night clothes until she changes her mind. 65. Failure to perform service for which a person is trained is called a. discrimination. b. malpractice. c. slander. d. false imprisonment. 66. After assisting a client to the bedside commode, the nurse aide SHOULD a. leave the curtain open so she can see the client. b. provide privacy with the curtain pulled. c. make her bed while she is sitting on the commode. d. tell her she can only use the commode once a shift. 67. The healthcare team can include all of the following EXCEPT for the a. nurse aide. b. registered nurse. c. receptionist. d. physical therapist. 68. In order to keep your job as a nurse aide, you will need to follow institutional guidelines that may include a. reporting to work on time. b. following the institution’s dress code. c. completing only tasks for which you have been trained. d. all of the above 69. Members of the healthcare team know that the MOST important reason to all work together is to a. provide the best possible care to the client. b. eliminate arguments among team members. c. form long-lasting friendships. d. be able to do each other’s assignments. 70. During a job interview, you should NEVER a. bring up your scheduling needs. b. make negative comments about your previous boss. c. ask about job responsibilities. d. share your strengths and weaknesses. –CHAPTER TITLE– 81 –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4–Exam 4 1. b. Explain to the patient what is located at each “time” using the clock method. This promotes independence. 2. b. Encourage Lena to do as much as possible by helping her obtain the materials she needs to perform this task. 3. b. This position will provide balance and support for the client. The cane should be properly fitted. 4. a. Nutritional status affects the health of the skin and other body systems. 5. c. Back rubs are soothing and promote blood flow to the area. 6. b. The planning phase of the nursing process can only be done by the registered nurse. 7. c. Proper instructions for hand placement prevent nerve damage, which may cause paralysis to the arm. 8. b. This is the maximum time a resident should be left in one position. Frequent turning promotes good circulation. 9. a. The neck is capable of all the movements listed here. 10. d. Bladder training promotes a regular pattern of continence. 11. a. Observe the patient who has a chewing dysfunction. Choking can cause an airway obstruction. 12. b. This may be an indication of a serious condition and should be reported immediately. 13. d. Inhaling the bacteria can cause infection to the healthcare worker. 14. c. A clean dressing is nonsterile but promotes protection to the skin. A Band-Aid is an example of a clean dressing. 15. d. Cleaning from the inside outward prevents contamination to the other eye. Using a clean cloth and reporting any drainage promotes healing. 16. a. The physician must order any treatments that the patient receives. 17. d. Check the skin frequently for redness and remove the soak if the patient complains of burning. 18. c. Ask the nurse if this is normal behavior for Mrs. Jewell. 19. c. Any unusual or new behavior should be reported for accurate diagnosis by the physician. 20. d. The lift ensures safety for both client and healthcare worker. It can be used on obese, paralyzed, or blind residents. 21. b. Never extend the joint to the point of pain. 22. a. A broad base of 12 inches apart will allow the center of gravity to assist in the transfer. 23. c. Changing the position of weights requires a doctor’s order. 24. c. The pillow provides safety and prevents the client from striking the head on the bed. 25. d. Sitting the resident on the side of the bed allows the blood to drain to the lower extremities and prevents the client from fainting. 26. a. The transfer belt provides a lift mechanism and prevents the client from falling. –CHAPTER TITLE– 82 Answers and Explanations –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4–27. d. Any sudden change in the client’s condition must be reported immediately. 28. b. Locking the brakes will prevent the chair from rolling and the client from falling. 29. d. Always know the procedure you are performing and use the proper equipment. 30. d. Though all of the listed options are pulse points, the radial pulse is located at the wrist and is most commonly used. 31. b. One ounce is 30 cc, so 5 ounces is 5 × 30 or 150 cc. 32. a. The pulse indicates tachycardia and the BP is abnormally low. These vital signs need to be reported immediately. 33. c. The drawsheet saves on bed changes and can be used as a lift sheet to move the client in bed. 34. b. When the client is bedridden, the bed sheets need to be changed with the client in bed. This is called an occupied bed. 35. a. Constipation is a common complication postoperatively from the effects from anesthesia. Not taking in adequate fluids will increase the risk of this complication. 36. b. Poor nail care can lead to infection in the diabetic client. Diabetic clients require licensed personnel to provide nail care. 37. d. Encourage independence as much as possible. 38. d. Clients vary in height and weight, and all equipment must be safe. 39. d. Encourage independence by using mechanical devices to assist the client. 40. c. In many mentally retarded clients, learning is slower than normal, but it still occurs and should be encouraged. 41. b. The diabetic patient needs to accept the amputation and realize this does not affect sexuality. 42. d. The Alzheimer’s patient suffers from physical and mental decline. 43. a. Calm the patient down and allow her to voice her concerns in a constructive way. 44. c. Lack of appetite may be caused by many diseases, especially depression. 45. c. Linda has a physical disorder but needs to continue to make her own decisions to keep her self-esteem and mental-health capability. 46. d. As middle-aged adults, parents worry about their teenage children and their elderly parents. 47. b. The nurse aide should make every effort to respect the client’s religious needs. 48. b. With learning usually comes greater appreciation and understanding. 49. b. Allow Beth to make decisions about her healthcare. This will prevent depression and allow her to make choices. 50. a. Gestures, facial expressions, and posture are all examples of body language. 51. a. Head nodding and smiling while someone is speaking to you demonstrates interest and says, “tell me more.” 52. d. Reflection is a communication technique in which the care provider uses key words the client says to reflect a main idea back to them. It allows the client to expand on the topic. 53. b. Always respect the client right of patient confidentiality. 54. c. Asking the question will help determine if there are any underlying physical or psycho- –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4– 83logical reasons why the client chooses not to bathe. 55. a. False imprisonment is the act of restraining another person. 56. d. As a team member, you are required to report this to the charge nurse. Any activity that affects patient care needs to be reported. 57. c. Always call the facility as early as possible so that they can find a replacement for you. 58. b. As a former foreman and leader, Mrs. Larkin needs to feel useful and involved. 59. d. If the daughter feels comfortable in caring for the client, she should let the nurse know. The nurse will consider the health of the client. 60. b. Terminally ill clients have physical and emotional needs that need to be met. 61. d. Both choices have a positive effect on the resident. 62. a. Always knock on a closed door and wait for a response to ensure client privacy. 63. d. All choices are listed in the Patient’s Bill of Rights. 64. c. As long as it is a safe choice, allow the client to make personal choices. 65. b. Malpractice is the failure to give service for which one is trained. 66. b. As long as the client is safe, provide privacy while on the commode. 67. c. The healthcare team is the group of caregivers involved in providing care to patients. 68. d. All of the guidelines listed are necessary to follow in order to remain employed as a nurse aide. 69. a. The primary function of the healthcare team is to provide the best patient care possible. 70. b. Saying negative comments about another person (slander) during a job interview will only cast a negative image upon yourself. Keep the interview positive. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4– 84TH I S I S T H E pull together all the tips you have been prac space to work, perhaps in an unfamiliar location such as a library, since you won’t be taking the real last sample National Standards Nursing Assistant Exam in this book. For this last test, ticing since the first test. Give yourself the time and the test in your living room. In addition, draw on what you have learned from reading the answer explanations. Remember the types of questions that tripped you up in the past, and when you are unsure, try to consider how those answers were explained. When you are done, check your answers and refer to Appendix A to find out on which sections you may need a final review. Most of all, relax. You have worked hard and have every right to be confident—good luck! C H A P T E R Nursing Assistant/Nurse Aide Practice Exam 5 CHAPTER SUMMARY This is the fifth and final nursing assistant exam. By the time you finish this exam, you should be prepared for the real thing. 7 85–NURSING ASSISTANT/NURSE AIDE ANSWER SHEET– 87 Exam 5 1. a b c d 2. a b c d 3. a b c d 4. a b c d 5. a b c d 6. a b c d 7. a b c d 8. a b c d 9. a b c d 10. a b c d 11. a b c d 12. a b c d 13. a b c d 14. a b c d 15. a b c d 16. a b c d 17. a b c d 18. a b c d 19. a b c d 20. a b c d 21. a b c d 22. a b c d 23. a b c d 24. a b c d 25. a b c d 26. a b c d 27. a b c d 28. a b c d 29. a b c d 30. a b c d 31. a b c d 32. a b c d 33. a b c d 34. a b c d 35. a b c d 36. a b c d 37. a b c d 38. a b c d 39. a b c d 40. a b c d 41. a b c d 42. a b c d 43. a b c d 44. a b c d 45. a b c d 46. a b c d 47. a b c d 48. a b c d 49. a b c d 50. a b c d 51. a b c d 52. a b c d 53. a b c d 54. a b c d 55. a b c d 56. a b c d 57. a b c d 58. a b c d 59. a b c d 60. a b c d 61. a b c d 62. a b c d 63. a b c d 64. a b c d 65. a b c d 66. a b c d 67. a b c d 68. a b c d 69. a b c d 70. a b c d Exam 5 1. Nursing orders frequently instruct you to “assist patient to cough and deep breathe.” This activity helps the patient avoid a. decubitus ulcers. b. pneumonia. c. internal bleeding. d. dyspnea. 2. What position should a patient be in to receive an enema? a. supine b. Fowler’s c. prone d. left Sim’s 3. Which of the following lists only items that would be included in fluid intake? a. milk, ham sandwich, ice cream bar b. water, mashed potatoes, gelatin c. milk, custard, soup d. orange juice, soft-boiled egg, toast 4. The nurse aide must use a stethoscope to determine the a. apical pulse rate. b. carotid pulse rate. c. popliteal pulse rate. d. brachial pulse rate. 5. Another name for urination is a. defecation. b. voiding. c. wetting the bed. d. flatus. 6. As you bathe Mrs. Sweeney, she complains of an ache or sore spot in her calf. You should a. massage her legs with lotion. b. stop the bath and ask the nurse to check the ache. c. tell Mrs. Sweeney to get up and walk to relieve the cramping. d. continue the bath and report the complaint to the nurse later. 7. An example of contamination through indirect contact is a. bathing the resident. b. touching instruments or linens the resident has used. c. the resident sneezing or coughing on you. d. all of the above 8. As you walk down the hall, you hear a scream and find smoke and flames coming from Mr. Smith’s room. You should a. attempt to get the resident out of the room if possible and close the door. b. throw water on the flames. c. take Mr. Smith’s cigarettes away. d. run to the telephone and call the fire department. 9. Placing a client in good alignment means you should a. keep his joints lubricated. b. keep him as straight as possible. c. keep him sitting up during the day. d. make sure he stands at least five hours per day. 10. When using a cane or walker, the resident’s elbows must be a. bent at a 60-degree angle. b. bent at a 15-degree angle. c. bent at a 90-degree angle. d. straight. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5– 8911. Which of the following conditions needs to be reported immediately to the charge nurse? a. rash that appears suddenly b. warm, dry, and pink skin c. tough skin on the feet d. scarred skin 12. To prevent a client from getting decubitis, it is necessary to a. wash urine and feces off with only water. b. put baby powder on the skin to keep it dry. c. rub the reddened area once a day. d. turn the client every 2 hours. 13. Mr. Brook has a broken hip and needs to have an enema. The best type of bedpan to use would be a a. fracture pan. b. plastic pan. c. child-sized pan. d. metal pan. 14. Which of the following is true regarding visually challenged clients? a. Clients use a “clock” system to locate food. b. Clients usually prefer to eat alone. c. Clients prefer to be fed to prevent spills. d. All of the above are true. 15. Before you ambulate a client who has a Foley catheter, the FIRST action would be to a. clamp off the catheter and disconnect it, since the bag would be in the way. b. leave the catheter dangling between the client’s legs. c. carry the bag below the level of the bladder. d. hide the bag in a pillowcase so the client will not be embarrassed. 16. After positioning a client, it is MOST important to a. examine the client thoroughly. b. close the door to the client’s room so she can rest. c. offer the client a drink of juice. d. check the position of nonfunctional limbs. 17. As you are transferring a client, the client becomes weak and starts to fall. Your FIRST action would be to a. hold the client’s transfer belt and lean away from the fall. b. call for help. c. grasp the transfer belt and lower the client to the floor along your bent leg. d. hold the client tightly and lean backwards. 18. Accurate daily weights are measured a. at the same time each day. b. with the client fully clothed. c. in the morning. d. all of the above 19. The MOST important factor in preventing the spread of infection is to a. place the client in isolation. b. wash hands between client contacts. c. clean the unit each day. d. wear sterile gloves to care for all clients. 20. The purpose of the cleansing bath is to a. provide cleanliness. b. promote circulation. c. observe skin condition. d. all of the above –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5– 9021. OSHA rules require all healthcare workers to be offered immunization against a. hepatitis B. b. hepatitis A. c. hepatitis C. d. AIDS. 22. When a client is placed on I and O after surgery, this means that you must a. measure only the first voiding after surgery. b. record the color of the client’s urine. c. record all fluid intake and output. d. record the first solid food the client eats. 23. Mr. Johnson has not had a bowel movement for five days. He might complain of a. abdominal cramping. b. lack of appetite. c. slight nausea. d. all of the above 24. Mr. Kull is weak and unsteady. He needs to urinate. You could safely leave him alone to use a. a bedside commode. b. the toilet. c. a bedpan. d. a urinal. 25. For a client who is classified as wound-and-skin isolation, the soiled linen should be a. placed in the linen hamper. b. discarded. c. bagged before removing from the room. d. taken directly to the laundry. 26. If a resident begins to choke while being fed and is unable to speak, the nurse aide should call for help and begin doing a. back blows. b. mouth-to-mouth ventilations. c. a finger sweep. d. abdominal thrusts. 27. When you make a bed, you should place the soiled linen a. on the bedside table. b. on the overbed table. c. in a laundry bag. d. on a chair. 28. You have come upon a patient lying on the floor who is not moving. Your first action should be to a. call for help. b. gently shake the victim and ask, “Are you all right?” c. check to see if the patient is breathing. d. check to see if the patient has a pulse. 29. If a client is receiving forced-fluid treatment, you should a. provide at least 2,000 cc of fluid per shift. b. provide high-protein fluids. c. offer liquids every hour. d. all of the above 30. When a client complains that his hearing aid is hurting, you should a. encourage him to leave the hearing aid in. b. report the complaint to the charge nurse. c. report the complaint to the physician. d. put the hearing aid in the bedside table. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5– 9131. Security for a client’s dentures includes a. keeping them in a tissue in a dresser drawer. b. placing them in a labeled denture cup. c. insisting the client wear the dentures. d. placing an identifying mark on the dentures. 32. A client who is too large for staff members to transfer safely is a. moved with a mechanical lifting device. b. placed on a calorie-controlled diet. c. left in bed, but turned every two hours. d. left in bed, but repositioned every hour. 33. Mr. Jones drinks five ounces of juice. You would record this as a. 500 cc. b. 150 cc. c. 6 cc. d. 5 cc. 34. Mr. Smith has just had a cup of hot tea. You need to take his temperature. You should a. take a rectal temperature. b. take an oral temperature immediately. c. wait 15–20 minutes and then take an oral temperature. d. give him some cold water, and then take an oral temperature. 35. Which of the following vital signs should be reported immediately? a. T–98.6, P–70, R–14, BP–120/60 b. T–95.4, P–40, R–10, BP–80/40 c. T–98.8 “R,” P–60, R–20, BP–132/70 d. T–97.6 “ax”, P–78, R–16, BP–110/60 36. The Patient’s Bill of Rights is a. A verbal agreement given to those receiving healthcare. b. A list of requests that patients submit when admitted to a healthcare facility. c. A written statement of rights entitled to those receiving healthcare. d. A bill for their stay at a healthcare institution. 37. When giving daily care, you should observe all clients for a. general appearance. b. mental condition. c. skin condition. d. all of the above 38. When should you wash your hands? a. after going to the bathroom b. before and after each client contact c. before eating d. all of the above 39. While bathing a resident, you notice a rash on both of her legs. You should a. ignore the rash if the resident hasn’t complained about it. b. scrub the rash to see if it disappears after the bath. c. notify the charge nurse at once. d. put alcohol on the rash to dry it out. 40. Nurse aides should report the care given to residents by a. telling the charge nurse directly. b. entering it in the chart. c. telling the desk clerk to tell the supervisor. d. leaving a note for the supervisor. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5– 9241. Mr. Brown starts to jerk and goes into a seizure while you are bathing him. You should a. hold him down so he doesn’t fall out of bed. b. shove the washcloth into his mouth. c. protect him from injuring himself. d. run and get help. 42. Body mechanics means a. the way the body parts are aligned with each other. b. always using a transfer belt. c. using the body in a safe and efficient manner. d. all of the above 43. To change your direction, you should a. turn your whole body by moving your feet. b. twist from the waist. c. move your body in sections. d. move very slowly. 44. To turn the client toward you, you should a. cross his far leg over the leg nearest you. b. cross his near arm over his chest. c. bend his far arm at the elbow. d. grab his shoulders and pull him toward you. 45. To help a client into a wheelchair, the nurse aide should position the chair a. at the side of the bed, facing the head of the bed. b. at the foot of the bed. c. at the head of the bed. d. at the side of the bed, facing the foot of the bed. 46. To transfer a resident correctly from the bed to a stretcher, you MUST a. use good body mechanics. b. use a Hoyer lift. c. have the help of seven coworkers. d. raise the side rail on the stretcher first. 47. Which statement about dressing residents is correct? a. Dressing is a waste of time for a handicapped resident. b. Residents are used to dressing in front of others. c. Residents care about what they wear. d. Residents like the nurse aide to dress them. 48. A mentally ill resident is likely to a. believe she is someone other than herself. b. be fearful, without good reason. c. live in her own world. d. all of the above 49. Reality orientation techniques include a. labeling items in the resident’s room. b. putting up calendars and clocks. c. using familiar items in the resident’s room. d. all of the above 50. Jane is a 24-year-old resident with muscular dystrophy. She has a supportive family, but she talks often of her desire to have a boyfriend. This feeling is best described as a. normal b. foolish c. both a and b d. hopeless 51. Rhonda, an 18-year-old, is a resident admitted for long-term rehabilitation. She tells you she wants to attend the local community college. This seems a. appropriate for her age. b. a waste of time. c. an excuse to leave the facility. d. a waste of money. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5– 9352. Two residents have decided to become a couple. They may a. hold hands. b. spend a lot of time together. c. insist on eating together. d. all of the above 53. Which statement about bathing for unconscious clients is correct? a. Unconscious clients may be able to hear you speaking to them during the bath. b. Unconscious clients can turn in bed when asked. c. Unconscious clients do not need to be observed for decubiti. d. Unconscious clients have very moist skin. 54. Mr. Dobbs wants to know what kind of surgery his roommate is going to have the next day. The best response by the nurse aide is a. “It really should not be any concern of yours.” b. “I’ll speak to the surgeon and find out.” c. “I cannot share that information with you.” d. “You can call the OR and ask yourself.” 55. The best and most effective form of communication is a. written communication. b. face-to-face communication. c. telecommunication. d. third-party communication. 56. A ten-month-old infant cries and pulls at his left ear. You should a. check the baby’s diaper. b. report this to the charge nurse. c. cuddle or rock the baby. d. all of the above 57. A client is hard of hearing and repeatedly turns her call light on. The nurse aide should a. take time to listen to her to determine her needs. b. talk loudly to her since she is hard of hearing. c. unplug the call light. d. tell the supervisor that the client is uncooperative. 58. If you are giving a client a tub or shower bath, you should a. ensure the client’s privacy. b. check the water temperature. c. gather all supplies before beginning. d. all of the above 59. A client who is eating poorly should be offered a. vitamin pills. b. tube feeding. c. clear broth. d. dietary supplements. 60. The nurse aide is encouraged to attend resident council meetings if a. invited to attend. b. the superior assigns you to attend. c. interested in what the residents are discussing. d. none of the above 61. It is Good Friday and a Catholic client was served chicken and requests a meatless meal. The nurse aide should a. offer to get another meal within the client’s diet. b. call the bishop for a dispensation. c. tell them that is all right since they are in the hospital. d. tell them the aide will check with the dietician for the next day’s meal. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5– 9462. A client is observing the Islamic Holy Month of Ramadan by fasting from sunup to sundown. The most appropriate action for the nurse aide would be to a. tell her that all clients have to eat at the same time. b. check with the doctor. c. find out when she may eat or drink. d. both b and c 63. An ECF resident tells the nurse aide something in confidence about her family. The nurse aide a. can tell any staff member. b. ethically cannot tell anyone else. c. can tell the charge nurse only. d. can tell anyone who does not know the resident. 64. A nurse aide observes a client fall in the hallway. It is important to report a. what she or he thinks happened. b. exactly what was observed. c. nothing if she or he chooses. d. all of the above 65. Which of the following behaviors may the client consider caring? a. making the client comfortable b. getting the work done before lunch c. showing interest in answering questions d. a and c only 66. Mrs. Farber is an 88-year-old resident on your floor. She has cared for herself and her husband until recently when he passed away. The nurse aide recognizes that Mrs. Farber needs to a. be involved in planning her own care as much as possible. b. be left alone to grieve for her husband. c. be told not to cry since it only upsets her. d. be involved in planning care for other residents. 67. A resident refuses to go to physical therapy one morning. The nurse aide reports this to the charge nurse, who discusses this with the resident. The resident states that she will go to physical therapy the next day. The nurse aide understands that the resident a. has the right to refuse treatment. b. should not be given choices in his therapy. c. does not have the right to refuse therapy. d. could refuse therapy only with the doctor’s permission. 68. A person admitted to a hospital or extended-care facility can be expected to be treated according to the a. State Hospital Association. b. Caregiver’s Bill of Rights. c. Patient’s Bill of Rights. d. Physician’s Association. 69. The nurse aide is told to bring a client by wheelchair to the X-ray Department and covers the client with a robe, blanket, and slippers. The nurse aide has maintained the client’s a. right to confidentiality. b. right to privacy. c. right to nursing-care plans. d. right to refuse. 70. Nurse aides need to identify themselves with their names and title of CNA before giving any care to clients. This is an example of the patient’s right to a. considerate and respectful care. b. privacy. c. identification of healthcare workers. d. be informed of hospital policies. –CHAPTER TITLE– 95 –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5–Exam 5 1. b. Coughing and deep breathing forces lowerlung movement. 2. d. The correct answer is left Sim’s. This allows better irrigation of the colon. 3. c. Only choice c lists liquids only. 4. a. Only a stethoscope can “hear” the apical pulse. 5. b. Voiding means urinating. 6. b. Always report patient complaints to the nurse as soon as possible. 7. b. The germs from the resident are on the soiled instruments and stay there until they are washed and sterilized. Wear gloves when washing dirty equipment. 8. a. Always try to rescue the victim first if possible; then call the fire department. 9. b. Body alignment promotes circulatory status and prevents contractions. 10. b. This position will create a balance between the resident and the walker to prevent a fall. 11. a. Of the answers listed, only a is an acute change. 12. d. Turning the client is the best way to protect against bedsores. 13. a. Choose a fracture pan so Mr. Brook will have a minimal distance to lift his hips. 14. a. Most blind patients can feed themselves in a dining-room setting if they can visualize their food on a plate. A clock system allows them to do this. 15. c. You cannot disconnect the bag without an order, but you still must ensure that the bag remains below the bladder level. Choice c is correct. 16. d. A client may be lying on a nonfunctional limb and have no awareness of it. 17. c. Grasp the transfer belt and lower the resident to the floor along your bent leg. 18. a. Weight may fluctuate during the day, so to be accurate you must weigh clients at the same time each day. 19. b. The most important factor in preventing the spread of infection is to wash your hands between client contacts. 20. d. A bath correctly given promotes circulation at the same time as it provides an excellent opportunity to observe the skin. 21. a. OSHA rules require all healthcare workers be offered immunization for hepatitis B. 22. c. I and O includes any liquid entering or leaving the body. 23. d. Lack of peristalsis causes all of these symptoms and must be documented and reported. 24. c. Keep the client in bed to prevent a fall, but allow privacy while voiding. 25. a. Wound-and-skin isolation means high likelihood of linen contamination, but according to Standard Precautions, all linen is considered potentially infective. 26. d. Abdominal thrusts are always the first step for airway obstructions. 27. c. Soiled linen should be directly placed in laundry bags to prevent contamination. 28. b. Determine that there is a problem before calling for help. –CHAPTER TITLE– 96 Answers and Explanations –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5–29. c. Choice a is incorrect because the doctor should specify the amount of liquid. Choice b is incorrect because a force-fluid diet is different from high-protein fluids. Choice d cannot be correct if a and b are incorrect. 30. b. Always bring such complaints to the charge nurse. 31. b. Every resident with dentures must have a labeled denture cup to ensure security of the costly dentures. 32. a. Use a mechanical device to protect both the client and the staff. 33. b. One ounce is 30 cc, so 5 ounces is 5 × 30 or 150 cc. 34. c. Drinking hot liquids may cause an abnormal reading on the thermometer. 35. b. This patient’s vital signs are all very low. 36. c. The Patient’s Bill of Rights is a written statement of the rights that patients are entitled to when receiving healthcare. 37. d. All observations are important in healthcare. 38. d. Standard precautions include washing your hands before and after patient contacts. 39. c. Any abnormality must be reported as soon as possible. 40. a. Reporting to the charge nurse or chain of command is in the role of the nurse aide as part of the health team. 41. c. Do not restrain the patient. Move all furniture and equipment away to protect him from injury. 42. c. Good body mechanics ensure safety for both the healthcare worker and the patient. 43. a. Moving the whole body prevents twisting the back muscles and an injury. 44. a. This will promote motion and help you move the patient. 45. d. Proximity of the bed to the chair will allow easier client transfer and the client will be facing the front of the room. 46. a. Body mechanics promote good musculoskeletal alignment. 47. c. Self-esteem promotes wellness. We all want to look nice and care about our personal appearance. 48. d. Thought processes of the mentally ill may include delusions and irrational fear. 49. d. These aids assist the resident to know where his room is and what date it is. 50. a. All patients need to feel wanted and to share their feelings with another person. This is normal behavior. 51. a. Rhonda wants to continue her education and socialize with people her own age. 52. d. Relationships are common in a nursing home and allow both individuals to feel needed and desirable. 53. a. The last sense to leave is hearing. Speak with kindness and be aware of what you say. 54. c. The response reflects confidentiality for all clients as well as an appropriate, nonoffensive response to the roommate. 55. b. Face-to-face communication is the most direct with the least chance for misinterpretation. 56. d. Crying indicates the infant needs attention; pulling at the ear could indicate an ear infection. Check or do all of the above. 57. a. Listening carefully to the client’s needs encourages communication and builds trust. 58. d. All of the responses given are correct. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5– 9759. d. Dietary supplements are high in the necessary vitamins and minerals. 60. a. The resident council is a meeting of the residents, and no staff may attend unless invited. 61. a. It is important to accommodate religious needs of the client. 62. c. It is important to accommodate cultural needs of the client; however, some patients’ health may become severely compromised if they do not eat for many hours. Islam generally allows exemptions in medical cases, so you should check with the doctor to confirm that the client’s health will not suffer as a result of fasting. 63. b. Anything told in confidence cannot be revealed. 64. b. All incidents need to be described exactly as observed. 65. d. Choices a and c are correct because comforting and interest or time to answer questions are behaviors that suggest caring. Choice b is incorrect because just getting work done is a fact or neutral behavior. 66. b. Residents have a right to be alone to grieve after the death of a loved one. 67. a. Residents can refuse treatment because of the Patient’s Bill of Rights. 68. c. All clients are treated according to the Patient’s Bill of Rights. 69. b. All clients have the right to privacy and should be properly covered at all times. 70. c. The right to know the identity of physicians, nurses, and others involved in their care. –NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5– 98ON E T R E N D I N strate that they can perform the tasks they learned in their training programs. In order to be cer- tified as a nursing assistant and be hired by a prospective employer, you will be asked to perform healthcare certification is the requirement that a job candidate physically demonfive randomly selected job-related skills. You will have approximately 25 minutes to perform these skills—you must execute five out of five correctly in order to pass. A nurse aide evaluator will assess and record your performance. On the next several pages is a listing of four job-related skills you might be asked to perform: taking vital signs, wheelchair use, measuring and reporting urinary output, and positioning a client on their side. There are instructions listed and a description of each skill. Gather the equipment—including a friend to act as your client—and then do each task as listed. Use the worksheet on the next page to record vital signs. Go over the skills checklist afterwards and make sure you did not miss any steps. On the actual day of testing, the evaluator will not instruct you or answer any questions. If you think you have made a mistake, tell the evaluator at the time and you will be allowed to go back and start again—one time only. Practice these skills until you become proficient. C H A P T E R Nursing Assistant/Nurse Aide Practical Skills Exam CHAPTER SUMMARY For most states’ certification requirements you will be asked to complete a performance evaluation—a hands-on test of your practical skills as well as a written or oral exam. This chapter gives a sample of the variety of job tasks you will be asked to do. 8 99 Sample Task: Vital Signs Instructions to Participant: 1. Using the necessary equipment and procedures, inform the client what you are doing. 2. Take and record the following: ■ Oral temperature ■ Radial pulse ■ Respiration rate ■ Weight Vital Signs Worksheet Client’s Number: Age: Gender: Oral Temperature: Radial Pulse: Respiration Rate: Weight: Recorded by: Signature: Evaluation Criteria Hand washing ■ Make sure paper towels are within reach ■ Turn on water at sink ■ Wet hands and wrists ■ Apply soap ■ Rub hands, wrists, and fingers for at least ten seconds ■ Rinse thoroughly ■ Dry with paper towel thoroughly ■ Use paper towel to turn off faucet ■ Dispose of paper towel into wastebasket Entry into the room and identification of self ■ Appropriate signal before entry into room ■ Identification of self to client Identification of client and explanation of procedures ■ Use of correct language level for client comprehension ■ Content of explanation Questioning of client ■ Audible questioning ■ Questioned about: eating, drinking, smoking, physical activity Procedure to obtain oral temperature ■ Mercury: Holds thermometer correctly and starts initial reading at 96 degrees or lower OR ■ Digital: Applies probe cover ■ Correct placement in mouth under tongue ■ Length of time in mouth (at least 3 minutes) Reading/recording of oral temperature ■ Reads thermometer and records temperature within ±0.2 degrees of examiner’s reading ■ Mercury: Rinses thermometer OR ■ Digital: throws away probe cover ■ Returns thermometer to storage Procedure to obtain radial pulse ■ Choice of proper site ■ Pulse regularity ■ Pulse assessment time Taking/recording of radial pulse ■ Rate ±2 beats ■ Rate, rhythm, volume recorded Procedure to obtain respiration ■ Respiration rate and character ■ Respiratory assessment time (one minute) ■ Records respiration ±2 breaths Taking/recording of weight ■ Scale correctly balanced or registering at zero without weight ■ Scale placed on a hard surface ■ Assists patient to step on the scale ■ Reports and records weight within ±1 pound of examiner’s reading –NURSING ASSISTANT/NURSE AIDE PRACTICAL SKILLS EXAM– 100 Sample Task: Wheelchair Use Estimated Completion Time: 20 minutes Instructions to Participant 1. Using the proper equipment, supplies, and techniques, complete the following: A. Transfer a client with left-side hemiplegia from a bed to a wheelchair. B. Push the wheelchair along a hallway. C. Demonstrate how to get in and out of an elevator. D. Transfer the client from the wheelchair to the bed. 2. When you have completed this procedure, inform the evaluator. Instructions to Evaluator The participant will demonstrate transferring a client from bed to wheelchair. The client will be wheeled down the hall and into and out of an elevator and returned to bed. Provide the following: Hospital bed Call bell Chart Transfer belt (optional) Wheelchair Lap robe Blanket Slippers Client with left-side hemiplegia and name bracelet Hand soap Sink Paper towels Elevator simulation (doorway with raised elevation) Evaluation Criteria Hand washing ■ Make sure paper towels are within reach ■ Turn on water at sink ■ Wet hands and wrists ■ Apply soap ■ Rub hands, wrists, and fingers for at least ten seconds ■ Rinse thoroughly ■ Dry with paper towel thoroughly ■ Use paper towel to turn off faucet ■ Dispose of paper towel into wastebasket Entry into the room and identification of self ■ Appropriate signal before entry into room ■ Identification of self to client Identification of client and explanation of procedures ■ Use of correct language level for client comprehension ■ Content of explanation Preparation of wheelchair ■ Places bed in appropriate and safest position for client ■ Positions wheelchair next to bed ■ Folds up footrests and locks brakes Assisting client to sitting position ■ Supports client and assists to sitting position with feet flat on the floor ■ Applies transfer belt (optional) ■ Makes sure resident has nonskid footwear on Assisting client to standing position ■ Uses body mechanics for lifting ■ Signals as transfer of client begins to standing position ■ Observes client as needed Assisting client into wheelchair ■ Pivots feet to turn to client ■ Gently lowers client safely into the wheelchair –NURSING ASSISTANT/NURSE AIDE PRACTICAL SKILLS EXAM– 101Client comfort and security in chair ■ Removes transfer belt ■ Adjusts client ■ Adjusts footrests ■ Gives client signaling device ■ Washes hands Wheelchair operation ■ Releases brakes ■ Stays to right of hallway (if applicable) ■ Enters and exits elevator by pulling backwards ■ Returns to room Return of client to bed ■ Placed chair on client’s unaffected side of bed ■ Applied brakes ■ Applied transfer belt (if applicable) ■ Moved footrests out of way ■ Used proper body mechanics to lift, pivot, and return patient to bed Client comfort and security in bed ■ Proper body alignment ■ Call belt in place (if applicable) ■ Side rails up Storage of wheelchair and other items ■ Folding and placement of chair in proper location Hand washing ■ Make sure paper towels are within reach ■ Wet hands and wrists ■ Apply soap ■ Rub hands, wrists, and fingers for at least ten seconds ■ Rinse thoroughly ■ Dry with paper towel thoroughly ■ Use paper towel to turn off faucet ■ Dispose of paper towel into wastebasket Sample Task: Measuring and Recording Urinary Output Evaluation Criteria Hand washing ■ Make sure paper towels are within reach ■ Wet hands and wrists ■ Apply soap ■ Rub hands, wrists, and fingers for at least ten seconds ■ Rinse thoroughly ■ Dry with paper towel thoroughly ■ Use paper towel to turn off faucet ■ Dispose of paper towel into wastebasket Measuring urine content ■ Puts on gloves ■ Pours contents of urine from bedpan into measuring container without spilling or splashing ■ Keeps the container level Cleaning the container and bedpan ■ Empties the container into the toilet cleanly ■ Cleans container with water; pours water into toilet ■ Cleans bedpan with water; pours water into toilet ■ Stores container and bedpan Recording urine output ■ Removes disposable gloves ■ Washes hands ■ Records content ± 25 ccs/mls of examiner’s reading –NURSING ASSISTANT/NURSE AIDE PRACTICAL SKILLS EXAM– 102 Sample Task: Positions Client on Side Evaluation Criteria Hand washing ■ Make sure paper towels are within reach ■ Turn on water at sink ■ Wet hands and wrists ■ Apply soap ■ Rub hands, wrists, and fingers for at least ten seconds ■ Rinse thoroughly ■ Dry with paper towel thoroughly ■ Use paper towel to turn off faucet ■ Dispose of paper towel into wastebasket Entry into the room and identification of self ■ Appropriate signal before entry into room ■ Identification of self to client Identification of client and explanation of procedures ■ Use of correct language level for client comprehension ■ Content of explanation Turning the client ■ Makes sure client has privacy ■ Lowers head of bed ■ Moves client’s body towards self ■ Raises side rail of bed ■ Supports client’s body and turns towards raised side rail ■ Adjusts client’s body properly ■ Covers client with bedding ■ Gives client signaling device ■ Leaves bed in lowest position ■ Washes hands –NURSING ASSISTANT/NURSE AIDE PRACTICAL SKILLS EXAM– 103TH E R E I S N O tion process for this profession should be, what types of classes should be in a training program for CNAs, or what kind of examination should be used to test the knowledge of people who want to be national organization of certified nursing assistants (CNAs) to say what the certificaCNAs. Neither are there any federal laws on education and training for nursing assistants. However, national standards have now been established for healthcare professions, and these standards are likely to lead to more regulation, at the state or national level, of professions such as CNAs. State Certification and Training Since OBRA (Omnibus Budget and Reform Act) was passed in 1987, the Federal Government has been setting regulations and creating standards for the quality of nursing-home care. Specific guidelines and standards were prescribed—one major change was the training and testing of nursing assistants/nurse aides. In many states, NAs are required to go through a minimum of 75 hours of training approved by the federal government to be certified. Most programs are between 75 and 150 hours and vary by state—the average number of training hours C H A P T E R Certification Requirements and Trends CHAPTER SUMMARY This chapter provides an overview of state certification and licensing requirements for nursing assistants. It will also help you keep abreast of the trends—what’s new in healthcare certification. 9 105is 80. Some states have created their own standards for nursing assistants. These standards include the minimum training requirements as well as a written exam of multiple-choice questions and clinical/ practical skills evaluation. Most healthcare facilities now require that nurse aides have a high school diploma or GED and pass a state-approved program. Nurse aides completing these programs must obtain certification within four months of being hired at a healthcare facility. Once you pass the written exam, you will be placed on your state’s registry for Nurse Aides—your certification is then valid for 24 months. After being certified, CNAs are usually required to earn continuing-education credits, usually through inservice training. Training Programs In New York State, 120 hours of training are required and a person must pass his or her clinical exam before taking the written (or oral) exam. Washington State requires 85 hours of training in a state-approved NA program along with at least seven hours of training in HIV and AIDS. In any states that require the certification of nursing assistants, the training program is likely to be similar to the samples shown on the following pages. The following are sample classes from a nurse aide training course given by the Nursing Assistant Training Institute in Shoreline, Washington. The classes consist of 40 hours of training, in addition to 12 hours of hands-on skills practice and demonstration, and 50 hours of clinical experience. 1. Role of the Nursing Assistant Rules and Regulations Governing Care Understanding Your Resident Physical and Psychosocial Aging Changes 2. Safety/Fire and Disaster Body Mechanics Transferring, Positioning, Ambulation Restraints: The Last Resort 3. Communication Medical Terminology Observations Vital Signs Height & Weights 4. Personal Care: Hygiene, Bathing, Grooming Oral Care, Foot Care, Skin Care, Decubitus Prevention Infection Control 5. Gastrointestinal & Urinary Systems Nutrition Fluids, Intake & Output 6. Rehabilitation & Restorative Concepts Prosthesis Specimen Collection Common Health Problems 7. Human Immunodeficiency Virus and AIDS 8. Blood Borne Pathogens: Hepatitis B & C, HIV Death and Dying 9. Cardiopulmonary Resuscitation and the Heimlich Maneuver 10. Understanding & Managing Difficult Behavior Dementia Care Preparation for Final & Competency Exam Source: Nursing Assistant Training Institute, http:// nursingassistanttraining.homestead.com Pennsylvania requires a minimum of 75 hours of training—37.5 hours of theory and 37.5 hours of clinical. Training programs throughout the state do vary—the Institute for Caregiver Education in Chambersburg, Pennsylvania, has a four-week, 140-hour nurse assistant training program. Topics covered include: Week 1: (35 hours) A. Communication B. Work Ethic C. Getting Along with Supervisors and Coworkers D. Attitude E. Customer Service F. Stress Management –CERTIFICATION REQUIREMENTS AND TRENDS– 106G. Time Management H. Problem Solving I. Conflict Resolution J. Teamwork K. Aging Sensitivity L. Special Needs Clients M. Managing Difficult Clients Weeks 2–4: (105 hours) A. Role and Function of the Nursing Assistant B. Infection Control C. Residents’ Rights D. Nutrition and Special Diets E. Personal Care Skills F. Bedmaking G. Transferring and Ambulating H. Death and Dying I. Post-Mortem Care J. Toileting and I & Os K. Aging Process—Review of Systems L. Vital Signs M. Data Collection and Observation Skills N. Rehab and Restorative Care O. Catheter Care P. Resident Assignments (beginning with one and working up to four residents per student) Q. Debriefing and Skills Review (after each day of clinical experience) Source: The Institute for Caregiver Education, www. caregivereducation.org A major part of the job of being a CNA involves being able to manipulate patients physically in order to clean them and help them change their clothes, exercise, or use the bathroom. The clinical part of the training programs help to determine if a student is capable of performing these tasks. Training programs are given in a number of settings, including both public and private vocationaltechnical schools, community colleges, public-health agencies, and for-profit and not-for-profit healthcare agencies, such as Visiting Nurse Associations. Since hands-on clinical experience is usually required, schools that do not have their own healthcare services often affiliate with a healthcare facility. Then the course work is given in the school and the clinical work is performed in the healthcare facility or in a home setting served by a healthcare agency. In the states that require certification, there are usually a large number of locations that offer training programs. In Illinois, for example, there are some 300 approved CNA training programs. Agencies that offer training programs often hire the people they have trained, so they are good places to sign up for a training program that may lead to a job offer when you complete the course. Exams Training programs usually conclude with a written (or oral) examination that determines whether the student is qualified to receive certification. Some institutions that offer training make up their own examinations, while others may use an exam prepared by a company that specializes in developing tests. Tests typically range from 50 to 150 questions and are in sections that relate directly to the subject areas covered in the training, such as patient-care procedures, emergency procedures, or observation and charting. Usually a candidate must achieve a passing grade in each of the sections, and not just overall, in order to qualify for certification. Why Certification? The main reason behind the trend to CNA certification is the growth of home healthcare. Home-based healthcare has been on the increase because of cost-saving measures in the health industry: Patients are being encouraged to leave relatively expensive hospital-based care to complete their recuperations in lower-cost alternative settings, including short-term and longterm care facilities, as well as the home. Nursing assistants work in a wide variety of healthcare settings, –CERTIFICATION REQUIREMENTS AND TRENDS– 107including skilled-nursing facilities, doctors’ offices, hospices, board-and-care retirement facilities, acutecare hospitals, clinics, rehabilitation hospitals, psychiatric hospitals, facilities for the developmentally disabled, and daycare facilities. But the delivery of services in patient homes is what has increased awareness of state and national authorities, leading to the increase of requirements for certification. Certification offers assurance that nursing assistants, who have such immediate, important, and intimate contact with elderly or disabled persons, have been properly trained to deal with the many and varied tasks they will have to perform. This is very important to the healthcare agencies that the CNAs work for, as well as to the families of the patients. The federal government, which is often the funding source for home healthcare under the Medicare program, also wants to know that its funds are being spent for highquality services. Emphasis on Interpersonal Skills While it has always been important for healthcare professionals of all kinds to be able to make patients feel safe and comfortable, these skills become even more crucial when care is being delivered in the patient’s own home or in long-term care. Thus, many training programs are now emphasizing interpersonal skills more than ever before. In the sample training programs shown earlier in this chapter, you can see interpersonal skills such as Understanding Your Resident in the first curriculum and Communication in the second curriculum are emphasized and listed at the beginning of each program. Combining CNA and Home Health Aide Certification The trend to certification is also spurred by the fact that the training programs for nursing assistants typically include the training requirements for the job of home health aide (HHA), as well. HHA training follows a federally mandated 75-hour curriculum. The federal mandate is there because home-healthcare agencies are eligible for Medicare funds for the services they provide to the elderly. Since CNAs can perform medical tasks beyond what HHAs are trained to do, someone who has training and certification in both job categories is obviously of greater value to the agency doing the hiring. The employer is better off hiring one person who can perform the work of two persons, even if that one person’s salary is a little higher than that of a person with one certification. A representative of one major home-healthcare agency in Austin, Texas, reported that the Sunday newspaper usually contains almost a full page of ads from home-healthcare agencies calling for people to work as home health aides. However, she noted that most of these ads want CNAs to fill these positions because they have skills that go beyond those required of a home health aide. The home health aide profession is growing faster than average and should continue growing through 2010. The reason for this is the increased need for home care of the elderly—patients are being moved out of hospitals and nursing homes to lower healthcare costs. In the year 2000, more than 600,000 people were employed as home health aides and most were employed in home-health agencies, nursing facilities, hospitals, visiting-nurse associations, residential-care facilities, and temporary-help firms. Full-time aides work about 40 hours per week, while many aides work part-time. The actual job can be difficult both physically and emotionally; it includes a good portion of standing, lifting, changing bed linens, and dealing with –CERTIFICATION REQUIREMENTS AND TRENDS– 108uncooperative clients. Generally a home health aide works independently and with a variety of patients. Supervisors visit sporadically, and the aide is always given explicit instructions pertaining to schedule and patient care. In Massachusetts, persons entering home health aide programs are often encouraged to undergo dual training and become CNAs in order to improve their employment opportunities. In some states, such as Illinois, people who want to become home health aides are required to take the same training program as CNAs. The HHA training is included within the program as part of the CNA training. As a result, the certification that follows the successful completion of the CNA training and the passage of the written competency examination serves as a dual certification for home health aides as well. And in November 2001, the state of Washington passed Initiative 775, founding a Home Care Qualitative Authority that will “regulate and improve the quality of long-term in-home care services by recruiting, training, and stabilizing the workforce of individual providers.” The good news for people who want to become nursing assistants is that the growth of healthcare in alternative settings ensures that workers will be needed. CNAs can look forward to good job prospects for the foreseeable future. –CERTIFICATION REQUIREMENTS AND TRENDS– 109IF YO U A R E go about finding a job—the resources listed in this chapter can give you valuable background informa- tion. Included here are lists of professional organizations, directories, placement services, and homecare just getting started on your new healthcare career—or if you are wondering how you can organizations. Professional Associations Professional associations are made up of experts in the nursing field. Both members and the people who run these organizations are actively working in, and on the behalf of, the fields they represent. Above all, they are great sources of information on possible careers, education and training programs, and professional requirements such as certification and licensure. In most cases, if these folks don’t have the information you need, they can tell you who will. In addition, many professional associations offer job placement or referral services. Many publish newsletters, magazines, books, and other publications, as well as multimedia products such as videos and CD-ROMs. C H A P T E R Important Resources CHAPTER SUMMARY This chapter identifies numerous healthcare organizations and services—potentially valuable resources in your search for the right job. 10 111Many also sponsor seminars, workshops, and other educational forums. All of these efforts can help interested individuals keep up on current happenings in a given field. Agency for Healthcare Research and Quality 2101 E. Jefferson Street, Suite 501 Rockville, MD 20852 Phone: 301-594-1364 www.ahrq.gov American Association for Homecare 625 Slaters Lane, Suite 200 Alexandria, VA 22314-1171 Phone: 703-836-6263 Fax: 703-836-6730 www.aahomecare.org American Association of Homes and Services for the Aging 2519 Connecticut Avenue NW Washington, DC 20008-1520 Phone: 202-783-2242 Fax: 202-783-2255 www.aahsa.org American Healthcare Association 1201 L Street NW Washington, DC 20005 Phone: 202-842-4444 Fax: 202-842-3860 www.ahca.org American Hospital Association (headquarters) One North Franklin Chicago, IL 60606 Phone: 312-422-3000 Fax: 312-422-4796 www.aha.org American Medical Association 515 North State Street Chicago, IL 60610 Phone: 312-464-5000 www.ama-assn.org American Public Health Association 800 I Street NW Washington, DC 20001-3710 Phone: 202-777-APHA Fax: 202-777-2534 www.apha.org Department of Health and Human Services 200 Independence Avenue SW Washington, DC 20201 Phone: 202-619-0257 Toll Free: 877-696-6775 www.os.dhhs.gov Home Care Aide Association of America 228 7th Street SE Washington, DC 20003 Phone: 202-547-7424 Fax: 202-547-3540 www.nahc.org/HCA/home.html Home Healthcare Nurses Association 228 7th Street SE Washington, DC 20003 Phone: 202-546-4754 www.hhna.org Hospice Association of America 228 7th Street SE Washington, DC 20003 Phone: 202-546-4759 Fax: 202-547-9559 www.hospice-america.org Hospice Foundation of America 2001 S Street NW, #300 Washington, DC 20009 Phone: 800-854-3402 Fax: 202-638-5312 www.hospicefoundation.org National Association for Home Care* 228 7th Street SE Washington, DC 20003 Phone: 202-547-7424 Fax: 202-547-3540 www.nahc.org *affiliates include Home Care Aide Association of America, Home Healthcare Nurses Association, Hospice Association of America, and Hospital Home Care Association of America National Council on the Aging (NCOA)* 409 3rd Street SW Suite 200 Washington, DC 20024 Phone: 202-479-1200 Fax: 202-479-0735 www.ncoa.org *geriatric care –IMPORTANT RESOURCES– 112National Rural Health Association One West Armour Boulevard, Suite 203 Kansas City, MO 64111-2087 Phone: 816-756-3140 www.nrharural.org Directories Consult the directories on the following list for . . . well, mostly more lists. Just like your local phone book, these directories offer you long lists of names, addresses, phone numbers, and contact persons—in this case, at hospitals, HMOs, private practices, geriatric facilities, and more. Directories can be especially useful when you are researching education programs or scoping out job prospects in your region or across the country. AHA Guide to the Health Care Field American Hospital Association One North Franklin, 27th Floor Chicago, IL 60606 Toll Free: 800-242-2626 www.ahaonlinestore.com (hospitals, clinics, other healthcare organizations) American Association of Homes and Services for the Aging 2519 Connecticut Avenue NW Washington, DC 20008-1520 Phone: 770-442-8633, ext 369 Toll Free: 800-508-9442 www.aahsa.org/public/books.htm (assorted books on geriatric care) American Medical Group Association 1422 Duke Street Alexandria, VA 22314-3430 Phone: 703-838-0033 Fax: 703-548-1890 www.amga.org (assorted books on physicians–private medical practices) Assisted Living and Extended Care Facilities, Hospital Blue Book, and Managed Healthcare Organizations Billian’s HealthDATA Group 2100 Powers Ferry Road Atlanta, GA 30339 Phone: 770-955-8484 Fax: 770-955-8485 www.billianshealthdata.com (assorted directories on healthcare facilities, hospitals, and managed-care organizations) Case Management Resource Guide AAHP/Dorland Directory of Health Plans Directory of Physician Groups & Networks Dorland Healthcare Information 1500 Walnut Street—Suite 1000 Philadelphia, PA 19102 Phone: 215-875-1212 Toll Free: 800-784-2332 Fax: 215-735-3966 Product Inquiries: [email protected] www.Dorlandhealth.com (healthcare facilities, HMOs, adult daycare, cancer centers, other) Directory of Privately Owned Hospitals, Hospital Management Companies and Health Systems, Residential Treatment Facilities and Centers, and Key Management Personnel Federation of American Hospitals 1405 North Pierce, Suite 311 Little Rock, AR 72207 Phone: 501-661-9555 (healthcare facilities nationwide) American Hospital Directory 3630-A Brownsboro Road, #200 Louisville, KY 40207-1861 Fax: 502-899-7738 www.ahd.com E-mail: [email protected] (hospitals) Medical and Health Information Directory Gale Research Company P.O. Box 9187 Farmington Hills, MI 48333-9187 Phone: 800-877-GALE Fax: 800-414-5043 www.galegroup.com E-mail: [email protected] (medical associations, schools, federal agencies, other) –IMPORTANT RESOURCES– 113 Placement Services and Job Searches Many organizations nationwide provide employment services for healthcare workers. In fact, it is a growing field precisely because the number of jobs is growing so fast. The list below covers just a few of the organizations and government agencies nationwide working to identify available jobs in healthcare, link candidates to employers and vice versa, or aid in the actual hiring process. Tip: For those of you who are savvy with online computer services, make the Internet and the World Wide Web part of your job-hunting process. Both private industry and government bureaus sponsor careerand employment-related websites. Virtually every major “search engine,” such as Yahoo or AltaVista, offers a list of predesignated employment databases or online classifieds to help you start your search. We have also included some pertinent website listings here. You also can tap into bulletin boards and discussion groups on the Internet that are frequented by healthcare professionals, where you can post your credentials, ask ever so politely for referrals, or respond to specific job listings. American Association of Managed Care Nurses, Inc. Job Placement Services 4435 Waterfront Drive, Suite 101 Glen Allen, VA 23060 Phone: 804-527-1905 Fax: 804-747-5316 www.aamcn.org American Nursing Services Phone: 800-444-NURS (6877) www.american-nurse.com American Public Health Association CareerMart (online only) www.apha.org/career CompHealth 4021 South 700 East, Suite 300 Salt Lake City, UT 84107 Phone: 800-453-3030; 801-264-6400 Fax: 801-264-6464 www.comphealth.com Department of Health and Human Services 200 Independence Avenue SW Washington, DC 20201 Phone: 202-619-0257 Toll Free: 877-696-6775 For 24-hour Job Information: 912-757-3000 www.hhs.gov/jobs (federal jobs) Department of Veterans Affairs 810 Vermont Avenue NW Washington, DC 20420 Phone: 202-273-5400 www.va.gov (federal jobs) Health Personnel Options 8150 Corporate Park Drive, Suite 300 Cincinnati, OH 45242 Phone: 513-936-3468 Toll Free: 877-936-4762 Fax: 513-891-6145 www.healthpersonnel.com (temporary assignments and temporary to permanent) NursingHands.com www.NursingHands.com/CC/ NursingJobs.com Phone: 877-435-2131 E-mail: [email protected] www.nursingjobs.com Nurse Web Search—The Nurse Directory www.nursewebsearch.com/nursing_employment.htm (provides listings of assorted websites for nurse-related issues, including employment) NurseZone 12235 El Camino Real, Suite 200 San Diego, CA 92130 Phone: 877-585-5010 Fax: 888-458-0197 www.NurseZone.com –IMPORTANT RESOURCES– 114 Homecare Organizations by State One of your best bets in finding a job is one of the more than 20,000 home-healthcare providers operating in the United States as of 2000. The National Association for Home Care (NAHC) defines homecare organizations as home-health agencies, homecare-aide organizations, and hospices. Types of homecare agencies include visiting-nurse associations (VNAs), public (government) agencies, proprietary (for profit) agencies, private not-for-profit agencies, and hospitalbased agencies. Members of the NAHC are featured in the stateby-state listing of homecare organizations below. ALABAMA Alabama Association of Home Health Agencies P.O. Box 40 Montgomery, AL 36101 334-395-9949 800-934-4312 334-832-1430 fax Medical Center Home Health 11491 US Highway 431 Albertville, AL 35950 256-878-7022 256-878-7067 fax ALASKA Alaska Home Care Association Geneva Woods Home Health Care 501 West International Airport Road Suite 1A Anchorage, AK 99518 907-565-6100 907-565-6112 fax ARIZONA Arizona Association for Home Care 2334 South McClintock Tempe, AZ 85282 480-967-2624 480-966-0442 fax Carondelet Home Health 1120 South Swan Road Tucson, AZ 85711 520-721-3822 520-512-0439 fax ARKANSAS Home Care Association of Arkansas 411 South Victory Suite 205 Little Rock, AR 72201 501-376-2273 501-376-7107 fax Home Health Professionals P.O. Box 704 Blytheville, AR 72316 870-762-1825 870-762-2299 fax Arkansas Hospital Association 419 Natural Resources Drive Little Rock, AR 72205-1576 501-224-7878 501-224-0519 fax www.arkhospitals.org CALIFORNIA California Association for Health Services at Home 723 S Street Sacramento, CA 95814-7021 916-443-8055 916-443-0652 fax www.cahsah.org Community Hospital Home Health Services/ Hospice of the Central Coast 555 Abrego Street Monterey, CA 93940 831-658-3901 831-648-7741 fax COLORADO Home Care Association of Colorado 7853 East Arapahoe Road Suite 2100 Englewood, CO 80112 303-694-4728 303-694-4869 fax www.hcaconline.org –IMPORTANT RESOURCES– 115Caring Plus 420 West 29th Street Pueblo, CO 81008 719-544-4197 719-544-0657 fax CONNECTICUT Connecticut Association for Home Care, Inc. 110 Barnes Road P.O. Box 90 Wallingford, CT 06492-0090 203-265-9931 203-949-0031 fax www.cthomecare.org VNA of Central Connecticut 205 West Main Street New Britain, CT 06052 860-224-7131 860-224-8303 fax DELAWARE Delaware Association of Home Care and Community Care Veale Road Professional Center 309 Veale Road Wilmington, DE 19810 302-529-3000 302-529-3009 fax Delaware Hospice Association 3515 Silverside Road Suite 100 Wilmington, DE 19810 302-478-5707 800-838-9800 302-479-2586 fax FLORIDA Associated Home Health Industries of Florida, Inc. 512 North Calhoun Street Tallahassee, FL 32301-2600 850-222-8967 850-222-9251 fax www.ahhif.org Prime Care Health Agency 3900 NW 79th Avenue, #334 Miami, FL 33166 305-591-7774 305-594-8951 fax Florida Hospital Association 307 Park Lake Circle Orlando, FL 32803 407-841-6230 407-422-5948 fax www.fha.org GEORGIA Georgia Association for Comprehensive Home Care, Inc. 2100 Roswell Road Suite 200C - PMB 407 Marietta, GA 30062 770-565-4531 770-565-1739 fax Georgia Association of Community Care Providers 168 North Johnston Street Suite 304 Dallas, GA 30132 770-445-6640 770-445-3893 fax Georgia Home Care Association 168 North Johnston Street Suite 304 Dallas, GA 30132 770-445-3180 770-445-3893 fax www.gahca.org Nursing Care, Inc. 205 Boulevard NE Gainesville, GA 30501 770-536-0484 770-536-3003 fax HAWAII Home Care and Hospice Division, Healthcare Association of Hawaii 932 Ward Avenue Suite 430 Honolulu, HI 96814-2126 808-521-8961 808-599-2879 fax www.hah.org Castle Home Care 46-001 Kamehameha Highway Suite 201 Kaneohe, HI 96744 808-247-2828 808-236-1337 fax –IMPORTANT RESOURCES– 116IDAHO Idaho Association of Home Health Agencies P.O. Box 6508 Boise, ID 83707 208-362-8190 208-562-1366 fax Guardian Home Care 119 South Valley Drive Suite C Nampa, ID 83686 208-461-1600 ILLINOIS Illinois Home Care Council 1926 Waukegan Road Suite 1 Glenview, IL 60025 847-657-6960 847-657-6963 fax Partners Home Care 2835 North Sheffield Avenue, #401 Chicago, IL 60657 773-549-5822 ext 150 773-549-9122 fax VNA First 47 South Sixth Avenue, Suite 120 LaGrange, IL 60525 708-788-2047 708-745-2920 fax www.vnaf.org INDIANA VNS—Indianapolis 4701 North Keystone Avenue Indianapolis, IN 46205 317-722-8200 317-722-8250 fax Indiana Association for Home and Hospice Care, Inc. 8604 Allisonville Road, Suite 260 Indianapolis, IN 46250 317-844-6630 317-575-8751 fax www.ind-homecare.org Interim HealthCare of ECI 2031 2 North Broadway Greenfield, IN 46140 317-467-0787 317-467-0790 fax IOWA Iowa Association for Home Care 1520 High Street, Suite 203-B Des Moines, IA 50309 515-282-3965 515-282-8034 fax www.iowahomecare.org Visiting Nurse Association 2530 University Waterloo, IA 50701 319-235-6201 319-232-7296 fax Iowa Hospice Organization 100 East Grant Avenue, Suite 120 Des Moines, IA 50309 515-243-1046 515-283-9358 fax Hospice of North Iowa 232 Second Street, SE Mason City, IA 50401 515-423-3508 515-424-7827 fax KANSAS Kansas Home Care Association 1512 B Legend Trail Drive Lawrence, KS 66047 785-841-8611 785-749-5414 fax www.kshomecare.org Stormont Vail Home Health 833 SouthWest Garfield Avenue Topeka, KS 66604 785-354-4300 785-354-1058 fax Association of Kansas Hospice 1901 University Witchita, KS 67213 316-263-6380 316-263-6542 fax Hospice Services, Inc. P.O. Box 116 Phillipsburg, KS 67661-0116 913-543-2900 913-543-5688 fax –IMPORTANT RESOURCES– 117LOUSIANA HomeCare Association of Louisiana 233-A East Main Street New Iberia, LA 70562 337-560-9610 337-560-9606 fax www.hcla2000.org Acadian Home Health 1340 Surrey Street Lafayette, LA 70501 337-233-1307 318-235-8037 fax MAINE Home Care Alliance of Maine 20 Middle Street Augusta, ME 04330 207-623-0345 207-623-7141 fax www.homecarealliance.org Kno-Wal-Lin Home Care 170 Pleasant Street Rockland, ME 04841 207-594-9561 207-594-2527 fax MARYLAND Maryland-National Capital Homecare Association 625 Slaters Lane Suite 200 Alexandria, VA 22314 703-535-1885 703-519-9066 fax Lauren Simpson Potomoc Home Health Care/Support 6001 Montrose Road, Suite 307 Rockville, MD 20852 301-896-6998 301-896-6275 fax MASSACHUSETTS Home & Health Care Association of Massachusetts 31 James Avenue, Suite 780 Boston, MA 02116 617-482-8830 617-426-0509 fax VNA of Southeastern Massachusetts 502 Bedford Street, 4th Floor Fall River, MA 02720 508-676-8251 508-646-4017 fax Massachusetts Council for Home Care Aide Services 31 New Chardon Street Boston, MA 02114 617-227-6641 617-227-1190 fax Health Force/Medi Force 60 Lowell Street Arlington, MA 02174 781-641-2800 781-646-3150 fax Visiting Nurses Association of New England 55 Charles Street Needham, MA 02194-2905 781-444-0713 781-449-6563 fax Community VNA of Attleborough 141 Park Street Attleborough, MA 02703 508-222-0118 508-226-1012 fax MICHIGAN Michigan Home Health Association 2140 University Park Drive, Suite 220 Okemos, MI 48864 517-349-8089 517-349-8090 fax www.mhha.org Henry Ford Extended Care 24445 Northwestern Highway, Suite 110 Southfield, MI 48075 248-352-4890 248-352-3224 fax MINNESOTA Minnesota HomeCare Association 1711 West County Road B, Suite 211S St. Paul, MN 55113-4036 651-635-0607 651-635-0043 fax www.mnhomecare.org –IMPORTANT RESOURCES– 118Perham Memorial Home Care 665 Third Street, SW Perham, MN 56573 218-346-1190 218-346-1237 fax MISSISSIPPI Mississippi Association for Home Care P.O. Box 1468 Ridgeland, MS 39158-1468 601-853-7533 601-853-7582 fax www.mahc.org Gilbert Home Health 605 2nd Ave North, #203 Columbus, MS 39701 662-327-9669 662-239-2015 fax Mississippi Hospital Association P.O. Box 16444 Jackson, MS 39236-6444 601-368-3220 601-368-3200 fax www.mhanet.org North Mississippi Medical Center Home Care/ Hospice Department 600 West Main Street Tupelo, MS 38801 662-841-3611 662-841-3990 fax MISSOURI Missouri Alliance for Home Care 2420 Hyde Park Road, Suite A Jefferson City, MO 65109 573-634-7772 573-634-4374 fax www.homecaremissouri.org John Knox Village Home Health 400 Northwest Murray Road Lee’s Summit, MO 64081 816-524-1133 816-524-9177 fax Missouri Hospital Home Health Council P.O. Box 60 Jefferson City, MO 65102 573-893-3700 573-893-2809 fax MONTANA Montana Association of Home Health Agencies 1905 River Road Missoula, MT 59801 406-721-4035 406-721-4035 fax www.mahha.org Flathead County Home Health Agency 711 East 13th Street Whitefish, MT 59937 406-862-9030 406-862-9025 fax Montana Hospital Association: An Association of Health Care Providers P.O. Box 5119 Helena, MT 59604 406-442-1911 406-443-3894 fax www.mtha.org NEBRASKA Nebraska Association of Home and Community Health Agencies 7421 Forbes Drive Lincoln, NE 68516 402-489-1117 402-489-1117 fax Good Samaritan Hospital Home Care Services 10 East 31st Street Kearney, NE 68847 308-865-7090 308-865-2923 fax NEVADA Home Health Care Association of Nevada P.O. Box 186298 Reno, NV 89511-0629 775-323-6003 775-853-2166 fax Washoe Home Care 780 Kuenzli Suite 200 Reno, NV 89502 775-982-5877 775-882-5795 fax –IMPORTANT RESOURCES– 119NEW HAMPSHIRE Home Care Association of New Hampshire 8 Green Street Concord, NH 03301 603-225-5597 603-225-5817 fax www.homecarenh.org Home Health & Hospice Care 22 Prospect Street Nashua, NH 03060 603-882-2941 603-883-1515 fax NEW JERSEY Home Health Assembly of New Jersey, Inc. 14 Washington Road, Suite 211 Princeton Junction, NJ 08550-1030 609-275-6100 609-936-9349 fax www.homecarenj.org Patient Care, Inc. 100 Executive Drive, Suite 130 West Orange, NJ 07052 973-669-5222 973-243-5901 fax Home Care Council of New Jersey 201 Bloomfield Avenue, Suite 3 Verona, NJ 07044 973-857-3333 973-857-1192 fax Certified Health Aide of Somerset County 205 West Main Street Sommerville, NJ 08876 908-725-5533 908-725-5648 fax New Jersey Hospital Association 760 Alexander Road P.O. Box 1 Princeton, NJ 08543-0001 609-275-4000 609-275-4265 fax www.njha.com NEW MEXICO New Mexico Association for Home Care 3200 Carlisle Boulevard NE, Suite 117 Albuquerque, NM 87110 505-889-4556 505-889-4928 fax www.nmahc.org Basin Home Health, Inc. 200 North Orchard Farmington, NM 87401 505-325-8231 505-325-4516 fax NEW YORK Home Care Association of New York State, Inc. 194 Washington Avenue, Suite 400 Albany, NY 12210 518-426-8764 518-426-8788 fax www.hcanys.org Independence Care Systems, Inc. 257 Park Avenue South New York, NY 10010 212-584-2580 212-584-2555 fax New York State Association of Health Care Providers, Inc. 90 State Street, Suite 200 Albany, NY 12207 518-463-1118 518-463-1606 fax www.nyshcp.org New York Nursing Care 527 Townline Road, Suite 302 Hauppauge, NY 11788 631-979-2200 631-979-2265 fax Health Care Association of New York State One Empire Drive Rensselaer, NY 12144 518-431-7600 518-431-7915 fax www.hanys.org Cayuga Medical Center at Ithaca 101 Dates Drive Ithaca, NY 14850 607-274-4443 607-274-4527 fax Hospice and Palliative Care Association of New York State 21 Aviation Road, Suite 9 Albany, NY 12205 518-446-1483 518-446-1484 fax www.hpcanys.org –IMPORTANT RESOURCES– 120Hospice of Central New York 990 Seventh North Street Liverpool, NY 13088-6148 315-634-2181 315-634-1111 Home Care Council of New York City 25 West 43rd Street, 3rd Floor New York, NY 10036-7406 646-366-0860 646-366-0864 fax Union Settlement Home Care 219 East 115 Street New York, NY 10029 212-828-6182 ext 204 212-828-6190 fax NORTH CAROLINA Association for Home Care and Hospice of North Carolina, Inc. 226 West Millbrook Road Raleigh, NC 27609 919-848-3450 919-848-2355 fax www.homeandhospicecare.org Baptist Hospital Home & Community Health Medical Center Boulevard Winston-Salem, NC 27157 828-252-2255 828-252-9355 fax The Carolinas Center for Hospice and End of Life Care 1011 Dresser Court Raleigh, NC 27609-7323 919-878-1717 919-878-0191 fax www.carolinasendoflifecare.org Johnston Memorial Home Care & Hospice P.O. Box 1376 Smithfield, NC 27577 919-989-1563 919-989-2129 fax NORTH DAKOTA North Dakota Association for Home Care c/o APT, Inc. P.O. Box 2175 Bismarck, ND 58502-2175 701-224-1815 701-224-9824 fax www.aptnd.com/ndahc Midwest Home Health Care 1711 South University Drive Fargo, ND 58103 701-280-2802 701-280-4030 fax OHIO Ohio Council for Home Care 1395 East Dublin Granville Road, Suite 350 Columbus, OH 43229 614-885-0434 614-885-0413 fax www.homecareohio.org Northcoast Health Care Group Co. Warrensville Center Road, #124 Shaker Heights, OH 44122 216-921-4000 216-921-3540 fax Ohio Hospice & Palliative Care Organization 1646 West Lane Avenue, Suite 2 Columbus, OH 43221 614-485-0021 614-485-0560 fax www.ohpco.org VNA of Cleveland Hospice 2500 East 22nd Street Cleveland, OH 44115-3204 216-931-1450 216-694-6355 fax OKLAHOMA Oklahoma Association for Home Care 8108 NorthWest Tenth, Suite C3 Oklahoma City, OK 73127 405-495-5995 405-495-5993 fax www.oahc.com Excell Home Health 5350 South Western Avenue Suite 301 Oklahoma City, OK 73109 405-631-0521 405-631-2661 fax OREGON Oregon Association for Home Care 1249 Commercial Street SE Salem, OR 97302 503-364-2733 503-399-1029 fax www.oahc.org –IMPORTANT RESOURCES– 121Willamette Valley Hospice 2700 Market Street, NE Salem, OR 97301 503-588-3600 503-363-3891 fax PENNSYLVANIA Pennsylvania Homecare Association 20 Erford Road, Suite 115 Lemoyne, PA 17043 717-975-9448 717-975-9456 fax E-mail: [email protected] www.pahha.org Home Nurse, Inc. 512 West Lancaster Avenue, Suite 2 Homestead, PA 19087 610-975-9600 610-975-0752 fax PUERTO RICO Puerto Rico Home Health Agencies and Hospices Association P.O. Box 192152 San Juan, Puerto Rico 00909-2152 787-774-8181 787-746-1066 fax RHODE ISLAND Rhode Island Partnership for Home Care, Inc. P.O. Box 603309 Providence, RI 02906 401-751-2487 401-751-2487 fax Memorial Hospital of Rhode Island Home Care 111 Brewster Street Pawtucket, RI 02860 401-729-3108 401-729-2754 fax SOUTH CAROLINA South Carolina Home Care Association P.O. Box 1763 Columbia, SC 29202 803-254-7355 803-252-0589 fax Tuomey Home Health 31 E. Calhoun Street Sumter, SC 29150 803-773-4663 803-436-5694 fax Hospice for the Carolinas P.O. Box 6009 West Columbia, SC 29171-6009 803-791-4220 803-791-5664 fax www.hospice-nc-sc.org Hospice of Charleston 3996 Leeds Avenue Charleston, SC 29405 843-529-3100 843-529-3111 fax TENNESSEE Tennessee Association for Home Care, Inc. 131 Donelson Pike Nashville, TN 37214-2901 615-885-3399 615-885-4191 fax www.tahc-net.org UT Medical Center Home Health 2220 Southerland Avenue, Suite 102 Knoxville, TN 37919 865-544-6200 865-544-6240 fax Tennessee Hospital Association Home Care Alliance 500 Interstate Boulevard South Nashville, TN 37210-4634 615-256-8240 615-242-4803 fax Gateway Home Care Gateway Medical Center Clarksville, TN 37040 931-648-4576 TEXAS Texas Association for Home Care 3737 Executive Center Drive, Suite 268 Austin, TX 78731 512-338-9293 512-338-9496 fax www.tahc.org Girling Health Care P.O. Box 4294 Austin, TX 78765 512-452-5781 512-302-1446 fax [email protected] (e-mail) –IMPORTANT RESOURCES– 122UTAH Utah Association of Home Health Agencies 6949 South High Tech Drive, Suite 150 Midvale, UT 84047 801-255-5888 801-568-6882 fax Health Watch 1750 North 680 West Orem, UT 84057 801-785-8848 801-785-0821 fax VERMONT Vermont Assembly of Home Health Agencies 10 Main Street Montpelier, VT 05602 802-229-0579 802-223-6218 fax www.vnavt.com Caledonia Home Health Care and Hospice P.O. Box 383 St. Johnsbury, VT 05819 802-748-8116 802-748-4628 fax VIRGINIA Virginia Association for Home Care 5407 Patterson Avenue, Suite 200B Richmond, VA 23226 804-285-8636 800-755-8636 804-288-3303 fax www.vahc.org Circle Home Care 600 Ridge Road Wytheville, VA 24382 540-228-0488 540-288-0489 fax Virginia Hospital and Health Care Association P.O. Box 31394 Richmond, VA 23294 804-965-1249 804-965-0475 fax www.vhha.com WASHINGTON Home Care Association of Washington P.O. Box 2016 Edmonds, WA 98020 425-775-8120 425-771-9588 fax www.hcaw.org Visiting Nurse Services of the Northwest 6100 219th Street SW, Suite 400 Mountlake Terrace, WA 98043 425-778-2400 425-744-2497 fax WEST VIRGINIA West Virginia Council of Home Care Agencies, Inc. Route 1, Box 190 Elk Fork Road Middlebourne, WV 26149 304-758-4312 304-758-4354 fax Elite Health Care 1832 Harper Road Beckley, WV 25801 304-256-0070 304-256-3703 fax WISCONSIN Wisconsin Homecare Organization 5610 Medical Circle, Suite 33 Madison, WI 53719 608-278-1115 608-278-4009 fax www.wishomecare.org Ministry Home Care 303 Upham Street, #208 Marshfield, WI 54449 715-387-9685 715-389-3950 fax WYOMING Home Health Care Alliance of Wyoming 1515 South Spruce Street Casper, WY 82601 307-237-7042 (phone and fax) Central Wyoming Home Care 401 East Main Riverton, WY 82501 307-857-0599 307-857-2778 fax –IMPORTANT RESOURCES– 123You can use the charts on the next five pages to assess the areas in which you need more study. The column on the left indicates the topics tested, and the right column indicates the question numbers in that topic. 125 APPENDIX Nursing Assistant/Nurse Aide Practice Exam Question OutlineNURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 1 PRETEST 1 Topic Question Numbers Activities of Daily Living 2, 9,10 Basic Nursing Skills 3, 4, 5, 6, 7 Restorative Skills 1, 8 TEST 1 PHYSICAL CARE SKILLS Topic Question Numbers Activities of Daily Living: 7, 12, 21, 22, 58, 59 ■ Hygiene ■ Dressing and Grooming ■ Nutrition and Hydration ■ Elimination ■ Rest/Sleep/Comfort Basic Nursing Skills: 1, 5, 6, 11, 15, 16, 17, 20, 23, 24, 25, 26, 28, 29, 30, 31, 32, 33, 35, 51, 55, 56, 57 ■ Infection Control ■ Safety/Emergency ■ Therapeutic/Technical Procedures ■ Data Collection and Reporting Restorative Skills: 8, 9, 14 ■ Prevention ■ Self-Care/Independence PSYCHOSOCIAL CARE SKILLS Topic Question Numbers Emotional and Mental Health Needs 37, 43, 44, 45, 46, 60 Spiritual and Cultural Needs 47, 48 ROLE OF THE NURSE AIDE Topic Question Numbers Communication 2, 3, 10, 13, 27, 49 Client Rights 18, 19, 36, 38, 40, 41, 42, 50, 54 Legal and Ethical Behavior 35, 52, 57 Member of the Healthcare Team 4, 34, 39, 50, 53 –APPENDIX– 126NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 2 PRETEST 2 Topic Question Numbers Activities of Daily Living 8, 9 Basic Nursing Skills 10 Restorative Skills 1, 2, 3, 4, 5, 6 Emotional and Mental Health Needs 7 TEST 2 PHYSICAL CARE SKILLS Topic Question Numbers Activities of Daily Living: 18, 19, 20, 23 ■ Hygiene ■ Dressing and Grooming ■ Nutrition and Hydration ■ Elimination ■ Rest/Sleep/Comfort Basic Nursing Skills: 1, 2, 3, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 17, 21, 24, 25, 26, 27, 28, 40, 56 ■ Infection Control ■ Safety/Emergency ■ Therapeutic/Technical Procedures ■ Data Collection and Reporting Restorative Skills: 4, 5, 22 ■ Prevention ■ Self-Care/Independence PSYCHOSOCIAL CARE SKILLS Topic Question Numbers Emotional and Mental Health Needs 31, 32, 33, 35, 36, 37 Spiritual and Cultural Needs 29, 55 ROLE OF THE NURSE AIDE Topic Question Numbers Communication 16, 34, 47, 48, 49, 58 Client Rights 30, 41, 42, 43, 44, 45, 50, 57, 59 Legal and Ethical Behavior 38, 39, 51 Member of the Healthcare Team 46, 52, 53, 54, 60 –APPENDIX– 127NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 3 TEST 3 PHYSICAL CARE SKILLS Topic Question Numbers Activities of Daily Living: 16, 24, 35, 37, 39, 57, 70 ■ Hygiene ■ Dressing and Grooming ■ Nutrition and Hydration ■ Elimination ■ Rest/Sleep/Comfort Basic Nursing Skills: 11, 12, 13, 14, 15, 17, 18, 20, 22, 23, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 47, 48 ■ Infection Control ■ Safety/Emergency ■ Therapeutic/Technical Procedures ■ Data Collection and Reporting Restorative Skills: 36, 38, 56 ■ Prevention ■ Self-Care/Independence PSYCHOSOCIAL CARE SKILLS Topic Question Numbers Emotional and Mental Health Needs 59, 60, 61, 63, 64 Spiritual and Cultural Needs 58, 65 ROLE OF THE NURSE AIDE Topic Question Numbers Communication 19, 43, 46, 49, 50, 52 Client Rights 21, 44, 45, 53, 54, 55, 62, 69 Legal and Ethical Behavior 40, 41, 42 Member of the Healthcare Team 51, 66, 67, 68 –APPENDIX– 128NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 4 TEST 4 PHYSICAL CARE SKILLS Topic Question Numbers Activities of Daily Living: 33, 34, 35, 36 ■ Hygiene ■ Dressing and Grooming ■ Nutrition and Hydration ■ Elimination ■ Rest/Sleep/Comfort Basic Nursing Skills: 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32 ■ Infection Control ■ Safety/Emergency ■ Therapeutic/Technical Procedures ■ Data Collection and Reporting Restorative Skills: 37, 38, 39 ■ Prevention ■ Self-Care/Independence PSYCHOSOCIAL CARE SKILLS Topic Question Numbers Emotional and Mental Health Needs 40, 41, 42, 43, 44, 45, 46 Spiritual and Cultural Needs 47, 48 ROLE OF THE NURSE AIDE Topic Question Numbers Communication 49, 50, 51, 52, 53, 54 Client Rights 58, 59, 60, 61, 62, 63, 64, 65, 66 Legal and Ethical Behavior 55, 56, 57 Member of the Healthcare Team 67, 68, 69, 70 –APPENDIX– 129NURSING ASSISTANT/NURSE AIDE PRACTICE EXAM 5 TEST 5 [Show More]

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