Your FREE CNA Flashcards 2026 – 200+ Cards

National Nurse Aide Assessment Program; NCSBN's nurse aide exam, administered by Credentia/Pearson VUE; the dominant national CNA exam.

Written (or Oral) Knowledge test AND a hands-on Skills Evaluation; must pass BOTH.

70 multiple-choice items.

60 scored + 10 unscored pretest items.

2 hours (120 minutes).

60 multiple-choice + 10 reading-comprehension (word recognition) items; 2 hours.

5 skills total.

30 minutes (5-minute warning at 25 minutes).

Hand Hygiene (Handwashing).

1 measurement skill + handwashing + 3 random skills.

Must pass 5 out of 5 skills.

A bolded step on the checklist; missing it = automatic fail of that skill.

Blood pressure, radial pulse, respirations, urinary output, weight.

Omnibus Budget Reconciliation Act of 1987; federal law requiring nurse aide training + competency testing + state registry.

75 clock hours (including at least 16 hours of supervised practical/clinical training).

A nurse aide cannot work more than 4 months in a certified facility without passing the competency evaluation.

State list of CNAs who passed the competency evaluation; required to work.

Generally every 2 years with evidence of paid nursing-related work.

Credentia (NNAAP, most states) and Prometric (some states).

A measurement value must fall within the official tolerance of the evaluator's reading, or the skill fails.

Only LATER handwashing may be verbalized; every other step of every other skill must be physically performed.

Most states allow 3 attempts within a set window (often ~2 years) before retraining is required.

Nurse Aide Training and Competency Evaluation Program — the state-approved course (75+ hours) required before testing.

At least 16 of the 75 federal training hours must be supervised practical (clinical) training before direct resident contact.

Treat ALL blood and body fluids of EVERY resident as potentially infectious.

Temperature, Pulse, Respirations, Blood Pressure (plus pain, SpO2).

96–99°F (35.8–37.3°C).

94.6–97.3°F (34.8–36.3°C); lowest reading route.

98.2–100.7°F (36.8–38.2°C); most accurate, highest reading.

96.9–100.2°F (36.1–37.9°C).

95.3–98°F (35.2–36.7°C).

Report temperature greater than 100.4°F (38°C).

60–100 beats per minute.

Less than 60 (bradycardia) or greater than 100 (tachycardia).

Thumb side of the wrist; count for 1 full minute.

Heart pulse heard with stethoscope at the apex; counted for 1 full minute.

10–20 breaths per minute (some refs 12–20).

Less than 10 or greater than 20.

Count without telling the resident (so they breathe naturally); 1 full breath = inhale + exhale.

Systolic 91–129 / diastolic 61–89 mmHg.

Systolic $\ge 130$ OR diastolic $\ge 90$ mmHg.

Top number; pressure when the heart contracts.

Bottom number; pressure when the heart rests.

Abnormally low blood pressure.

BP drop on standing; dizziness/fall risk.

95–100%; report below 90% (supplemental reference).

Device measuring oxygen saturation, usually on a fingertip.

Usually 0–10 (0 = no pain, 10 = worst); report pain to the nurse.

Snug, 1 inch above the elbow, bladder over the brachial artery; arm at heart level.

Hand hygiene (handwashing).

At least 20 seconds with friction.

Keep fingertips DOWN and hands LOWER than elbows.

Turn off with a clean paper towel (or knee/foot control); never with bare hands.

Never touch the inside of the sink.

Before and after every resident contact, before/after gloves, after toileting, before food.

Personal Protective Equipment: gown, mask, goggles/face shield, gloves.

Gown → Mask → Goggles → Gloves.

Gloves → Goggles → Gown → Mask (gloves first because dirtiest).

Always work from cleanest area to dirtiest.

For organisms spread by touch (e.g., MRSA, C. diff); gown + gloves.

For organisms in respiratory droplets (e.g., flu); mask.

For tiny airborne particles (e.g., TB); N95 respirator + negative-pressure room.

Healthcare-associated infection (acquired in the facility).

Clean technique to reduce spread of microbes.

Free of all microbes; outside the CNA scope.

Contaminated items into labeled biohazard/sharps containers.

Agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host.

Bend the knees (not the back), wide base of support, lift with legs, hold load close, never twist.

Never lift alone if unsafe; use a gait/transfer belt or get help/mechanical lift.

Belt around the resident's waist over clothing to assist standing/transfer/ambulation.

Call light in reach, bed in LOW position, non-skid footwear, clear pathways, lock wheels.

Always place within the resident's reach before leaving.

Lowest position, wheels locked.

Hold cane on the STRONG (unaffected) side.

Abdominal thrusts (Heimlich maneuver) for a conscious choking adult.

Rescue, Alarm, Confine, Extinguish.

Pull, Aim, Squeeze, Sweep.

Any device limiting movement; last resort, requires a doctor's order, never for staff convenience.

Check frequently (commonly q15–30 min) and release/reposition (commonly q2h).

Test water temperature; protect residents with reduced sensation.

No smoking/open flames near oxygen.

Measurable/observable (e.g., BP 150/95, redness).

What the resident reports (e.g., "I feel dizzy").

Observe, record, and REPORT changes to the nurse.

Sudden change in condition, abnormal vitals, chest pain, difficulty breathing, fall, skin breakdown, bleeding.

Document only care actually performed; never chart ahead or what wasn't done.

Diagnose, assess (nursing assessment), prescribe, or give medications (unless a certified med aide).

Tracking all fluids in and out; recorded in mL/cc.

Redness over bony areas, broken skin; report and reposition q2h.

20+ seconds of friction, fingertips down/hands below elbows, paper towel to turn off faucet, never touch the inside of the sink.

Contact precautions PLUS soap-and-water handwashing — alcohol gel does NOT kill C. diff spores.

Airborne precautions — N95 respirator and a negative-pressure room.

Droplet precautions — a surgical mask.

At least every 2 hours to prevent pressure injuries (bedsores).

Sacrum, hips, heels, and elbows — common pressure-injury sites to inspect.

Count for a full minute without telling the resident; one rise + fall = one breath.

Count the radial or apical pulse for a full minute; note rate, rhythm, and force.

Rectal reads highest and is most accurate; axillary (armpit) reads lowest and is least accurate.

Abdominal thrusts for a CONSCIOUS choking adult who cannot speak, cough, or breathe.

Encourage coughing — do not interfere.

Activities of Daily Living: bathing, dressing, grooming, toileting, eating, mobility/transferring.

Dress the weak/affected side FIRST; undress the strong side first.

Sit resident upright at 90° (Fowler's) to prevent aspiration/choking.

Difficulty swallowing; use thickened liquids, small bites, allow time, sit upright.

Inhaling food/fluid into the lungs; major choking/pneumonia risk during feeding.

Feed slowly, offer small amounts, alternate food and liquids, let resident chew/swallow.

Nothing by mouth (Latin nil per os).

Always wipe front to back (clean to dirty) to prevent UTI.

Turn head to the side to prevent aspiration.

Line sink with towel + water to prevent breakage; use cool/tepid water; store in cool water.

Comfortably warm (about 105°F / 40.5°C); always test before use; check for skin breakdown.

Wash eye from inner canthus to outer canthus; use clean area of cloth for each eye.

Clean to dirty; face first, perineal area last.

Inability to control bladder or bowel; provide prompt peri-care to protect skin.

Provide privacy, knock, cover resident, allow time.

Measure urine at eye level on a flat surface; record in mL/cc.

Reduce noise/light, position comfortably, manage pain reports to nurse.

About 105°F (40.5°C); always test it before bathing to prevent scalds.

Keep the resident upright for 30–60 minutes after eating to prevent aspiration.

Wipe from the inner corner to the outer corner, using a clean part of the cloth for each eye.

Keep it below the level of the bladder, off the floor, with no kinks in the tubing.

CNAs do NOT cut the nails of diabetic residents — report the need to the nurse.

Use cool or tepid water (hot water warps dentures); line the sink to prevent breakage.

Dry thoroughly between the toes; apply lotion everywhere EXCEPT between the toes.

Helping residents regain/maintain function and independence to their ability.

Let residents do what they can themselves; assist, don't take over.

Moving joints through their full movement to prevent stiffness/contractures.

Resident performs the movements themselves.

CNA moves the joint for the resident.

Support the joint above and below; move slowly to the point of resistance, NOT pain; never force.

Permanent shortening/tightening of a muscle/joint from disuse; prevented by ROM.

Muscle wasting from disuse.

Walking; assist with gait belt and proper footwear.

Cane, walker, gait belt, wheelchair; promote safe mobility.

Artificial body part (e.g., limb); care for skin and device.

Brace/splint supporting a body part.

Scheduled toileting to restore continence.

Move away from / toward the midline of the body.

Bending / straightening a joint.

Active ROM = the resident moves themselves (preferred); passive ROM = the CNA moves the joint.

Repeat each movement the number of times in the care plan (commonly ~3–5); exercise both sides.

Move the walker forward, then step into it; all four tips on the ground before stepping; never on stairs.

Ease them to the floor while protecting the head — do not try to hold them upright.

Use a gait belt and walk slightly behind and to the weaker side, ready to support.

Physiological → Safety → Love/Belonging → Esteem → Self-actualization.

Most basic: food, water, oxygen, elimination, sleep — met first.

Unconscious way of coping with stress (denial, projection, regression, rationalization, displacement).

Refusing to accept reality.

Reverting to earlier/childlike behavior under stress.

Denial, Anger, Bargaining, Depression, Acceptance.

Comfort/palliative care for the terminally ill (focus on quality, not cure).

Care focused on comfort and symptom relief.

Decreased responsiveness, irregular/slowed breathing, cool/mottled skin, loss of bladder/bowel control.

Care of the body after death with dignity and respect.

Progressive loss of cognitive function (memory, reasoning).

Most common type of dementia.

Increased confusion/agitation in the late afternoon/evening.

Aimless walking; ensure safety, do not restrain.

Stay calm, reassure, redirect, avoid arguing, reduce stimulation.

Encourage choices, independence, grooming, and dignity.

Increase evening light, reduce noise/clutter, limit caffeine, keep evenings calm.

Approach from the front at eye level, identify yourself, smile, and use a calm low voice.

Report to the nurse IMMEDIATELY — never keep it confidential or handle it alone.

Cycles of fast and slow breathing with pauses, a sign that death is approaching.

Hearing is believed to be the last sense lost — keep speaking gently and reassuringly.

With a firmly confused resident, validate feelings and redirect — do not argue or reorient.

Respecting each resident's beliefs, values, and practices.

Honor religious/cultural diets (kosher, halal, vegetarian).

Arrange clergy/services per resident's wishes; provide privacy; do not impose your beliefs.

Vary by culture; observe and respect resident preferences.

Provide privacy and gender-appropriate care per resident's cultural/religious needs.

Handle rosaries, prayer beads, and holy books with care and respect; never discard or move them.

Honor religious diets per the care plan; never serve a forbidden food.

Provide privacy and leave; it is a privacy matter, not a behavior to report or stop.

Spoken/written words.

Body language, facial expression, tone, touch, gestures.

Supportive techniques: active listening, open-ended questions, silence, clarifying.

Cannot be answered with yes/no; encourages the resident to share.

Face the resident, speak clearly at normal/slightly lower pitch, reduce background noise.

Announce your presence, describe surroundings, explain before touching.

Loss of ability to speak/understand language; use yes/no questions, allow time, communication boards.

Simple short instructions, calm tone, approach from the front, redirect, validate.

Reporting = telling the nurse verbally; Recording = documenting in the chart.

Face the resident, sit at eye level, give full attention, allow silence, and reflect what you heard.

Talking down or baby talk to an older adult; a communication barrier to avoid.

Saying 'you'll be fine' dismisses feelings; a barrier to therapeutic communication.

Document objectively and factually, AFTER care is given — never chart ahead or what you didn't do.

Federal Nursing Home Reform Act / OBRA '87 (42 CFR 483).

Personal and medical information is protected.

Choose schedule, clothing, activities, food when possible.

Complain without fear of retaliation.

Protected from physical, verbal, sexual, financial abuse and neglect.

No unnecessary physical/chemical restraints.

Treated with dignity; privacy during care.

Resident may refuse care.

Security of personal money and belongings.

Resident and family councils.

Law protecting private health information (PHI); share only on need-to-know basis.

Separating a resident against their will; a form of abuse.

A competent resident may refuse any care or treatment; report the refusal to the nurse, never force it.

Knock and wait, close doors/curtains, drape the resident, and expose only the area being cared for.

The official term for stealing or misusing a resident's belongings — a form of abuse.

Report a SUSPICION immediately to the nurse; you do not need proof and do not investigate yourself.

Residents have the right to manage their own money or designate someone, with access to records.

Intentional infliction of harm (physical, verbal/psychological, sexual, financial).

Failure to provide needed care/services.

CNAs MUST report suspected abuse/neglect immediately to the nurse/supervisor.

Failure to provide the expected standard of care, causing harm.

Negligence by a professional.

Threatening to touch/harm someone without consent.

Touching someone without their consent.

Restraining or confining a resident improperly.

Harming reputation by false statements (libel = written, slander = spoken).

Exposing a resident or sharing their information improperly.

Resident agrees to care after understanding it.

Legal document stating care wishes (living will, DPOA for health care).

Do Not Resuscitate order; no CPR.

Document stating wishes for end-of-life treatment.

Person authorized to make health decisions if resident cannot.

Requires a physician's order; never for convenience or punishment; least-restrictive.

Standards of right conduct (honesty, accountability, respect).

Taking responsibility for one's actions.

Requires a physician's order, is a last resort and least restrictive, never for convenience or punishment.

Defamation: slander is spoken, libel is written.

Never falsify documentation or chart care you did not perform — it is fraud and unethical.

CNA → LPN/LVN → RN → physician/DON.

CNAs work UNDER a licensed nurse (RN or LPN/LVN).

The tasks a CNA is legally permitted and trained to perform.

A nurse assigns a task; CNA accepts only if within scope, trained, and safe — may refuse unsafe/out-of-scope tasks.

Assessment, Diagnosis, Planning, Implementation, Evaluation (CNAs assist with implementation and report data only).

Individualized plan of care; the CNA must follow it.

RN/LPN, physician, PT, OT, SLP, dietitian, social worker, activities staff.

Restores mobility/strength.

Helps with ADLs/daily function.

Treats speech/swallowing problems.

Plans nutrition and special diets.

Documentation of an accident/unusual event (e.g., a fall).

Punctuality, reliability, appearance, ethics, teamwork, respect.

Director of Nursing.

Minimum Data Set; standardized resident assessment in nursing homes.

The nursing process: Assessment, Diagnosis, Planning, Implementation, Evaluation — only the nurse assesses, diagnoses, plans, evaluates.

Restores ADL skills (dressing, eating, grooming) and fine motor function.

Restores mobility, strength, balance, gait, and transfers.

Treats speech, language, communication, and swallowing (dysphagia) problems.

Addresses emotional, social, financial, and discharge-planning needs.

Right task, right circumstance, right person, right direction/communication, right supervision.

Keep the resident safe, do NOT move them if injury is suspected, and report to the nurse immediately.