Texas CNA Skills (Part Sixteen): Facts About the CNA State Examination

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The National Nurse Aide Assessment Program, or NNAAP for short, is also known as the CNA state examination. In essence, this is the two-part exam that nurse aide candidates must pass in order to obtain state certification as a certified nursing assistant (CNA) in the state of Texas. In addition, Pearson Vue is the corporation entrusted with administering the CNA state examination in Texas, as well as many other states.

The CNA state examination consists of two sections. The first section is the written examination, which consists of 70 multiple choice questions. Of these 70 questions, only 60 will be graded. However, the test taker is not made aware regarding which questions will be graded, so it is important to answer all questions correctly and to the best of one’s ability. Test takers have approximately two hours to take the written examination.

Test takers who either cannot read well or simply feel uncomfortable with a written test can choose to have the written examination administered orally in their choice of either English or Spanish. When the written examination is administered orally, the test taker receives earphones in order to listen in as the exam questions are transmitted by way of an mp3 player. Each test question can be repeated via mp3 player up to two times.

The second section of the CNA state examination consists of a comprehensive hands-on skills evaluation. During the skills evaluation, the test taker is given 30 minutes to demonstrate five random procedural skills in the presence of a nurse aide evaluator (NAE) who observes and grades them as they are performed. The test taker will receive a laminated card with a listing of the five skills that he or she must perform.

All test takers will be called upon to perform the hand-washing skill in Texas as part of the skills evaluation section of the CNA state examination. This is because hand hygiene is the single most effective action nurse aides can take to prevent the spread of infections. Moreover, all test takers can expect to receive a minimum of one random measurement skill to perform in front of the nurse aide evaluator.

The five testable measurement skills include the following: weighing an ambulatory resident, measuring and recording blood pressure, measuring and recording respiration rate, measuring and recording urinary output, and measuring and recording pulse. The results of measurement skills must be properly documented on a sheet of paper provided by the Pearson Vue testing center. When recording a weight, the test taker must indicate whether the result is in pounds (lbs) or kilograms (kgs).

The other skills are selected completely at random based on the laminated card that the test taker is given. Most skills will be demonstrated on another test taker. At the Pearson Vue testing center, each test taker is paired with another test taker. The pair must perform skills on each other. For instance, a test taker who is asked to perform foot care and a partial bed bath will be performing these skills on their partner.

The only hands-on skills that are not performed on another live person include hand-washing, perineal care, urinary catheter care, and applying a stocking to one leg. The test taker will wash his or her own hands, of course. On the other hand, perineal care and urinary catheter care will be performed on a female mannequin. The stocking skill will also be performed on a mannequin.

Test takers should arrive at the Pearson Vue testing center approximately 30 minutes prior to the scheduled testing time. This is crucial because people who arrive late are sent home, automatically forfeit their testing fees and must reschedule. Also, they should plan to remain at the Pearson Vue testing center all day. Test takers are made aware of their passing or failing result prior to leaving the testing center that same day.

REFERENCES

Pearson Education. (2018). Texas Nurse Aide Candidate Handbook. Retrieved May 21, 2019, from https://home.pearsonvue.com/getattachment/73a0c524-4cbe-401a-aa5c-fe1ebf4e2517/Texas%20Nurse%20Aide%20Candidate%20Handbook-064400.aspx

 

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Texas CNA Skills (Part Fifteen): Providing Foot Care

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The following list is a sequence of steps on the proper way to provide foot care to a client during the skills demonstration section of the CNA state examination. Keep in mind that test takers and candidates will be performing the foot care procedural skill on an actual person, not a mannequin.

  1. The candidate knocks on the door.
  2. The candidate identifies the resident.
  3. The candidate introduces himself or herself.
  4. The candidate explains that he or she is there to perform foot care.
  5. The candidate provides for privacy using a door, privacy screen or curtain.
  6. The candidate washes his or her hands.
  7. The candidate gathers the supplies needed to complete foot care.
  8. The candidate places the supplies on the over-bed table.
  9. The candidate places a barrier such as a bed protector or chuck pad on the floor.
  10. The candidate dons gloves.
  11. The candidate removes a sock from one foot and places it on the over-bed table.
  12. The candidate adds warm water to a bath basin.
  13. The candidate checks the water’s temperature with his or her wrist.
  14. The candidate directs the resident to check the water’s temperature with his/her finger or wrist before placing one entire foot in the bath basin.
  15. The candidate applies soap to one wash cloth and gets it lathered up and soapy.
  16. The candidate washes the entire foot, making sure to scrub between the toes.
  17. The candidate rinses the entire foot using another wash cloth with the rinse water from the bath basin, making sure to submerge the resident’s foot in the water.
  18. The candidate removes the resident’s foot.
  19. The candidate pats the foot dry, including the areas between the toes.
  20. The candidate applies a quarter-sized amount of lotion to his or gloved hands and warms it up by rubbing between both hands.
  21. The candidate applies lotion to the resident’s feet, making sure to avoid rubbing any lotion between the toes.
  22. The candidate must wipe away any excess lotion.
  23. The candidate cleans the resident’s area and removes the supplies.
  24. The candidate rinses the bath basin and dries it with a clean paper towel.
  25. The candidate places the bath basin and supplies in the appropriate area.
  26. The candidate places all dirty linens in the hamper and and throws away any trash that may have accumulated.
  27. The candidate removes his or her gloves and discards them.
  28. The candidate places the bed in the lowest position.
  29. The candidate places the call light or signaling device within reach.
  30. The candidate opens the door or privacy screen.
  31. The candidate asks the resident if anything else is needed before he or she leaves the room.
  32. The candidate washes his or her hands.
  33. The candidate documents the procedure and announces that the skill is complete.