Scholastic Spotlight: the Art of Taking Notes

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We know. It is a widely known fact that not all pupils enjoy the tasks of writing or taking notes. To some students, writing and note-taking are tedious activities they would simply prefer to not do at all. On the other hand, note-taking is one of the most crucial actions students can take to promote their own active learning. This rings especially true for those enrolled in healthcare training programs and health science coursework.

Alas, a multitude of convincing reasons exist for the sheer importance of taking notes in school. Thus, for the sake of time, only the most significant rationale will be pointed out here: taking good quality notes tends to help students remember and recall important material that they would have otherwise forgotten. Recall and remembrance of crucial material is very essential when studying for quizzes, tests and the state exam.

To reiterate that point, taking notes is a really important task. This fact has already been established. However, taking notes correctly and efficiently is not always as simple a task as it appears to be on the surface. Good, effective note-taking does not just call upon students to write down every word the instructor or professor says in a haphazard way. In fact, effectual note-taking entails capturing main ideas in the student’s own words.

One recurrent theme most good students share is the fact that they adhere to a specific way of taking notes in class. A specific note-taking style assists students to focus and organize prior to class; in addition, it helps them effectively review and recall crucial concepts long after class has ended. Adhering to one note-taking style and sticking with it will help students pay attention during class while capturing important information.

Sticking to one specific style of taking notes has an array of other study-related benefits, too. For some students, it bestows more than enough motivation upon them to stay attuned to class discussions, pay close attention and participate in an active manner. It helps students reword their notes effectively so they do not lose focus of the main concepts and ideas once they start studying for final exams.

The following list provides an overview of the different styles of taking notes in school settings. It is advised to pick one method and try to stick with it unless another style of note-taking seems more suitable for the topic of study. Of course, now that this information is out here, students may take it and utilize it as they wish. Students are also totally free to avoid using any of this information at their own peril).

  • Flow-Based Note Taking Style: a way of taking notes in which the pupil writes down the main concepts instead of verbatim paragraphs and sentences. The student connects the written notes and concepts by drawing arrows, boxes and diagrams to link them together as interrelated ideas.
  • The Cornell Note Taking Style: a method of taking notes that organizes class topics of discussion into easily memorable summaries. This style works since the main concepts and summaries are all written in one place. In the Cornell Method, the note paper is divided into 3 sections: a 2.5” margin to the left, a 2” summary section on the bottom, and a main 6” in-class note section.
  • The Bullet Point Style: this is a method of taking notes that involves simply jotting down each noteworthy detail as a bullet point sentence. This style of note-taking works particularly wonderful for capturing important points in class discussions that are moving along quickly, as wells as fast-paced lectures that are filled with a great deal of information.
  • The Outline Style: this method is, in all likelihood, the most popular way to take notes in schools. This style of note-taking involves an outline to organize the noted material in a structured, logical manner that forms somewhat of a skeleton of the textbook chapter or lecture subject and serves as a wondrous study guide when preparing for tests (Missouri State University, n.d.).

REFERENCES

Missouri State University. (n.d.). Outlining Method for Note Taking. Retrieved March 16, 2019, from https://www.missouristate.edu/assets/busadv/p.24.pdf

Texas CNA Skills (Part Twelve): Understand the Patient Care Scenario!

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The CNA state test consists of  a written section as well as a hands-on clinical skills portion. The clinical skills section of the CNA state exam test is comprised of multiple procedural skills interwoven into a simulated patient care scenario that has been formulated to resemble situations nursing assistants aides normally encounter during the course of a shift at the workplace.

The clinical skills section of the CNA state test is administered in a simulated caregiving situation that will look almost exactly like the patient care environment in which most nursing assistants are expected to function. Unless specified otherwise, all the equipment and supplies a test taker needs during the clinical skills section of the CNA state test will be supplied by the testing site.

The skills section of the CNA state test will be designed to seem as realistic as possible. Also, the test taker will perform the hand-washing skill the on first instance it is needed in the test. However, after the first hand-washing demonstration, all other moments that require hand hygiene will only need to be verbalized. For instance, after performing foot care, the test taker would verbalize, “Now I would wash my hands.”

The patient care scenario will be typed on a sheet of paper or index card and handed to the test taker by the testing site evaluator. In most cases the testing site evaluator will read the scenario instructions to the test taker before the clinical skills section of the CNA state test is slated to begin.

The ‘patient’ who participates in the simulated patient care scenario is usually another test taker who has graciously volunteered to step into that role. In other words, test takers will perform hands-on skills on each other during the CNA state test. Test takers who volunteer to pose as a patient must adhere to a predetermined dress code.

However, instances do arise where performance of a procedural skill on a mannequin would be far more appropriate. For instance, if the scenario card involves an intimate skill such as perineal care or urinary catheter care, the test taker will demonstrate it on a mannequin rather than another person.

The following is an example of a simulated patient care scenario that is similar to what one would receive during the skills section of the CNA state test.

Sample Scenario 

Ms. Hernandez: Hand-washing / Manual Blood Pressure / Give Modified Bed Bath / Mouth Care / Position on Side

Ms. Hernandez is a 65-year-old long term resident of Curry Hills Nursing & Rehab Center who has hypertension and major depressive disorder. She has refused showers for the third day in a row due to her depressed mood. When you enter Ms. Hernandez’s room, you find her laying in bed. She is wearing a hospital gown, bra and underwear.

You will wash your hands and check Ms. Hernandez’s blood pressure manually before giving her a modified bed bath. You will perform oral care prior to positioning her on her side. You will leave Ms. Hernandez in a position of safety and comfort. You will document as needed while providing the care.

 

Informative YouTube Channel

A newer YouTube channel has been created! The YouTube channel for the Legacy Healthcare Careers Nursing Assistant School can be accessed by clicking here

Legacy Healthcare Careers’ very own YouTube channel contains a host of informative videos on different topics that pertain specifically to nursing assistants and aspiring CNAs. Some of these topics include the CNA state test, hands-on skills for nurse aides, written practice questions with answers, dress codes, and additional information that nursing assistants might be able to utilize in their daily practice as healthcare clinicians.

In summary, if you are an experienced CNA, current nurse aide student, direct care worker, caregiver, or perhaps just entertaining the idea of becoming a nursing assistant one day in the distant future, you may wish to visit our channel on YouTube to see if the assorted pearls of wisdom found within the short videos may be of benefit to you.

As always, prospective students in the Dallas-Fort Worth area of Texas should contact Legacy Healthcare Careers Nursing Assistant School to obtain quality, fast-track, affordable nurse aide training in as little as 7 days. Yes, you did read that last blurb correctly: Legacy Healthcare Careers offers a unique 1-week CNA program that could help you transition into a new healthcare career as a nursing assistant in just 7 days.

In the very near future, Legacy Healthcare Careers will also offer a brand new certified medication aide training program to prospective students in the Dallas-Fort Worth metro area. The staff of Legacy Healthcare Careers is in the beginning phases of adhering to the multiple regulatory steps associated with the addition of the medication aide classes to the school’s current course offerings. More details will be added as the development of the certified medication aide training program reaches completion time.

Call (682)626-5266 to schedule an appointment time to enroll or visit the school’s website to submit an online application for enrollment at www.LegacyHealthcareCareers.com.

 

CNA State Examination Practice Questions (Part Four)

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QUESTION: The resident has returned to the nursing home this afternoon after having undergone a minor same-day surgery at a freestanding surgical center earlier this morning. The resident has a doctor’s order to receive a full liquid diet for the rest of the day. The resident is now telling the nursing assistant, “I am getting really hungry right now.” Which food items and fluids would be appropriate on the meal tray of a resident who has been prescribed a full liquid diet?

A. Cream soup, broth, vanilla ice cream, water, and orange juice

B. Chicken noodle soup, sliced apples, side salad, and hot tea

C. Turkey bacon sandwich, corn on the cob, pudding, and milk

D. Spaghetti with meatballs, green beans, chocolate cake, and cola

ANSWER: A (The full liquid diet consists of fluids and food items that are usually in liquid form, as well as food items that will melt into liquid form when they are at room temperature, such as ice cream, ice cubes and popsicles. The full liquid diet allows the resident’s body to heal from the recent surgical procedure).

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QUESTION: The charge nurse has told the nursing assistant, “The patient in room 209 is in shock.” The nursing assistant knows to place the patient in which of the following positions in bed if any signs and symptoms of shock are noted:

A. The high Fowler’s position

B. The Trendelenberg position

C. The Sims’ position

D. The low Fowler’s position

ANSWER: B (The nursing assistant would place the patient in the Trendelenberg position when the signs and symptoms of shock are being experienced by the patient. This position places the legs of the patient in an elevated position that is higher than the head. This position also promotes return of the blood in the extremities (arms and legs) back into the circulating blood, therefore increasing the patient’s blood volume and blood pressure. The Sims and Fowler’s positions cannot produce these effects).

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QUESTION: The instructor is teaching a group of nurse aide students about the various roles of the different members of the multidisciplinary team within a typical nursing home setting. The instructor knows that her teaching has been effective if the nurse aide student is able to correctly pair the following healthcare worker with the associated duties and functions:

A. Dietitian: meal preparation

B. Speech language pathologist: instruction of new languages

C. Physical therapist: ambulation and balance/gait exercises

D. Certified nursing assistant: ordering medications

ANSWER: C (Physical therapists deliver rehabilitative and restorative care techniques, including assistance with ambulation and balance/gait exercises. Speech language pathologists, also known as speech therapists, assess and treat residents who are afflicted with swallowing disorders; in addition, they assess and treat residents with speech disorders and communicative problems that sometimes happen after a stroke. Speech language pathologists do not teach people new languages.

The primary role of a dietitian in the nursing home setting is to formulate nutritional programs designed to improve or maintain the health statuses of the residents who reside there; conversely, they do not prepare meals in the nursing home setting. Ordering medications is not within the scope of practice for certified nursing assistants).

 

CNA State Examination Practice Questions (Part Three)

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QUESTION: The nursing assistant has been assigned to deliver care to a patient who has been placed on contact precautions. The nursing assistant is selecting the appropriate personal protective equipment (PPE) attire to wear prior to delivering care to a patient who has been placed on contact precautions if which of the following items will be worn:

A. Gloves and a gown

B. Gloves, gown, and a face mask

C. Gloves, gown, a face mask, and a face shield

D. Gloves, gown, a HEPA mask, and a face shield

ANSWER: A (Contact precautions require the use of gloves and a gown at the very minimum. Droplet transmission precautions require the use of a medical face mask at the very minimum. Airborne transmission precautions, at the minimum, require the use of a negative pressure room and a HEPA mask, also known as a particulate respirator).

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QUESTION: The nurse aide student is attending a nursing assistant class this morning. The nurse aide instructor asks all the students, “What is the single most important action that nursing assistants and other healthcare workers take in order to prevent the spread of infections?” The nurse aide student is providing a correct response when he gives which of the following answers:

A. Wearing personal protective equipment before delivering care

B. Performing hand-washing before and after delivering care

C. Adhering to universal precautions before delivering care

D. Using clean technique prior to delivering care

ANSWER: B (Hand-washing is the single most important action that nursing assistants, nurses, and other healthcare workers can take in order to prevent the spread of infection. Adhering to universal precautions, utilizing personal protective equipment in a correct manner, and using clean technique also reduce the spread of infections. Nonetheless, hand-washing is the single most important action that can be taken by all healthcare workers to prevent the spread of infection).

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QUESTION: The nurse aide student is learning about documentation and charting during this morning’s nursing assistant class. The nurse aide student asks the instructor, “Who is responsible for the documentation at the hospital or nursing home?” The correct answer is which of the following responses:

A. The registered nurse (RN) is accountable for everything, including documentation of all care provided by the nursing assistants

B. The licensed practical / vocational nurse (LPN /LVN) should document all care, including the care provided by the nursing assistants

C. All members of staff, including nursing assistants, need to document the care that they have provided

D. All members of staff need to document the care that they have provided, and the physician will sign off on the documentation

ANSWER: C (All members of nursing staff, including nursing assistants, are responsible for documenting and signing off on all of the patient care that they have personally delivered. For instance, the nursing assistants will chart the showers and bed baths that they have given to the patients. The licensed practical /vocational nurses will chart all of the wound care and medications that they have administered to the patients. The registered nurse will chart the various nursing diagnoses that they have formulated and the patient assessments that they have performed. Generally, physicians are not required to sign off on the patient care documentation of nurses and nursing assistants in the hospital and/or nursing home settings).

CNA State Examination Practice Questions (Part Two)

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QUESTION: The nursing assistant observes a very small fire in the outdoor smoking area of the skilled nursing facility where he works. He has been trained to extinguish small fires through nurse aide training and annual fire safety in-service training at his place of employment. This nursing assistant is following the proper sequence for using a fire extinguisher if he:

A. Pulls the fire extinguisher’s pin, aims at the base of the fire, squeezes the fire extinguisher’s handle, and sweeps in a back and forth motion.

B. Aims at the base of the fire, pulls the pin, squeezes the handle of the fire extinguisher, and sweeps in a back and forth sweeping motion.

C. Pulls the pin of the fire extinguisher, gently shakes the fire extinguisher, aims at the base, squeezes the handle of the fire extinguisher, and sweeps in a back and forth sweeping motion.

D. Aims at the middle of the fire, pulls the pin, squeezes the fire extinguisher’s handle, ans sweeps in a back and forth sweeping motion.

ANSWER: A (the proper sequence of steps to use a fire extinguisher can be readily recalled by remembering the PASS acronym, which stands for PULL-AIM-SQUEEZE-SWEEP. P = pull the pin out to activate the fire extinguisher. A = aim the fire extinguisher toward fire’s base. S = squeeze the fire extinguisher’s handle to facilitate expulsion of the container’s contents. S = sweep in a back and forth motion across the fire’s base as the contents of the fire extinguisher are expelled).

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QUESTION: The nursing assistant has strong suspicions that a CNA coworker might be verbally abusing an elderly patient at the post-acute rehabilitation center where they both work. What is the first action that the nursing assistant must take?

A. Place a telephone call to the local sheriffs department to report the suspicions of abuse. Ensure the names of the resident and suspected abuser are available just in case more information is requested.

B. Report the suspected abuse to the charge nurse or facility administrator.

C. Privately confront the suspected abuser and demand that she immediately stop verbally abusing the elderly patient.

D. Do nothing at the moment since the nursing assistant only has suspicions of possible verbal abuse without any substantiated proof.

ANSWER: B (nursing assistants are mandated reporters who are legally mandated to report all instances of witnessed abuse, as well as any suspected abuse and neglect. The nursing assistant does not need proof of suspected abuse in order to report it; rather, a designated person will investigate the allegation of abuse. The nursing assistant should not call the sheriffs department since the administrator and/or charge nurse knows to adhere to facility procedures for initiation of investigations of alleged abuse).

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QUESTION: The nursing assistant student is currently learning about principles of infection control during this evening’s nurse aide lessons at school. The instructor has made all students in the classroom aware that some questions regarding infection control might be included on the written section of the CNA state test. The student answers the instructor’s question correctly if she responds that the following entity is a host of infection:

A. A wadded piece of toilet paper contaminated with stool

B. A stethoscope contaminated with the microbe that causes whopping cough

C. A sick patient who is currently infected with tuberculosis

D. A sick dog who is currently infected with rabies

ANSWER: C (according to the chain of infection, an infected human being is a host of infection. A vector is a living nonhuman, such as an infectious dog, mice, tick or mosquito, that can transmit infections to humans. A fomite is an inanimate object, such as used toilet paper, contaminated equipment, and unclean door knobs, that can potentially spread infection via direct contact).

Texas CNA Skills (Part Eleven): Pearls of Wisdom from Nurse Aides Who’ve Passed the CNA State Examination

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Due to legislation that had been enacted and implemented in the late 1980s, nurse aides must obtain state certification as certified nursing assistants (CNAs) if they want to secure employment in certain healthcare facilities that accept federal dollars. The Omnibus Budget Reconciliation Act of 1987, more simply known as OBRA, established the minimum acceptable standards for nurse aide training.

The overarching goal of nurse aide training programs is to sufficiently prepare students in nursing assistant programs with the practical knowledge, clinical skills, and procedures that must be adhered to by members of staff at all skilled nursing facilities that receive federal payments. In simpler wording, OBRA is the very reason that nurse aides must attain CNA certification if they want to work at these types of workplaces.

So, this is the burning question. How in the world does a nurse aide obtain certification as a CNA? The answer to this question is the following: a nurse aide becomes certified in a particular state by passing the national CNA state exam utilized by that state. A wonderful way to become more familiar and confident with the setup of the CNA state exam is to obtain feedback from nurse aides who have taken and passed the test.

The following responses are from multiple nurse aides who possess firsthand experience in regards to taking the CNA state exam. The responses provided by these nurse aides pertain mainly to the successful completion of the skills section of the CNA state exam. Keep in mind that a written (or oral) section of the CNA state exam exists as well.

The individual and collective insights provided by these nurse aides that pertain to the CNA state test are rather enlightening. In addition, readers can learn quite a bit of new information from the varied perceptions and recollections of these nurse aides’ different experiences with the CNA state exam. Therefore, read and pay close attention to recurrent themes within the responses such as the importance of performing the procedural skills using the correct sequence of steps.

NURSE AIDE ONE: “If you mess up on a step or just forget to complete a step, you will simply lose points. If you forget to do a bold step (also known as a critical element step), or perform it wrongly, you fail the entire skill by default. You should be able to pass the CNA state test as long as you remember to perform the bold steps and always do them right.”

NURSE AIDE TWO: “You will need to do the skills in the exact order on the skills handbook or you will not pass. So, in your spare time, practice on other people or dolls until you have each step memorized. If you can memorize each and every move, you will pass your CNA state test with flying colors.”

NURSE AIDE THREE: “Where I live, the person who watches you do the skills on the CNA state test is looking for you to perform the tasks in the order listed on the handbook. If you perform the tasks out of order, but do them right, points get deducted from the total score.”

NURSE AIDE FOUR: “On the CNA state test I did the steps as I had learned them since I knew I would have forgotten to do something really important if I strayed from what I learned. All the steps are there for a reason. So I suggest you instill them into your memory bank as best as you can.”

NURSE AIDE FIVE: “Do all the steps in the exact order for the skills.”

NURSE AIDE SIX: “I took lessons for CNA and each time when I took the skills exam part of the CNA state test, we needed to complete every skill correctly step by step. It is because these steps were placed and organized the right way so as to cut down on the chances of cross contamination and to teach you the best way to do the skills for the best care of the residents.”

Texas CNA Skills (Part Ten): General Guidelines for the CNA State Exam

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The following list is a set of general guidelines to help future nurse aide test takers know what to expect when taking the CNA state test.

  1. Always remember to speak with the patient to whom you are providing care, even if it might be a manikin. Effective communication entails introducing oneself and clearly explaining the procedural skills, which is all part of the skills section of the CNA state test.
  2. Equipment for the procedural skills will be available at the testing center. The nurse aide evaluator will give the test taker a list of all the equipment needed for the procedural skills that will need to be performed. It is the responsibility of the test taker to gather all the equipment. Thus, the test taker should gather and organize all needed equipment in a manner that is easiest for him or her.
  3. At the moment the skills competency section of the CNA state test begins, the test taker is allotted approximately 30 minutes to work through all of the assigned procedural skills.
  4. The test taker is required to wash his or her hands at the beginning of the simulated patient care scenario for the CNA state test. Hand-washing is the first procedural skill to be performed. The test taker is expected to perform hand hygiene by using hand sanitizer at other moments during the CNA state test as needed.
  5. The patient’s privacy and safety must be upheld during the entirety of the simulated patient care scenario. In addition, strict compliance with infection control techniques must be sustained during the entire scenario for the CNA state test.
  6. The test taker will need to physically work through each step associated with every procedural skill he or she has been assigned for the CNA state test. Once the skill is started, if an error is made, the test taker must say so and correct himself or herself. The test taker will be expected to complete the step that was missed.
  7. For the CNA state test, side rails are utilized only for safety with certain procedural skills performances. At other times, the side rails should be in the low position.
  8. Always keep in mind that the CNA state test should be reflective of the test taker’s provision of basic nursing care duties to a real patient and performance of direct hands-on care for that person.
  9. For the skills competency section of the CNA state test, the test taker can be safe to assume that he or she will be performing the skills on one patient and/or manikin and will not be alternating from resident to resident as a typical nursing assistant would in a nursing facility setting. The test taker must become proficient at all of the testable skills in addition to the opening procedures and closing steps for each skill.

REFERENCES

Lewis-Clark State College. (2013). Student Skills Packet. Retrieved from http://www.lcsc.edu/media/117278/2013-Student-Skills-Packet.pdf

CNA State Examination Practice Questions (Part One)

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As nursing assistant students enrolled in a nurse aide training program, a number of steps exist that can be taken to promote mastery of the knowledge and skills needed to pass the CNA state test. A few of these steps include cultivating top-notch study habits that are conducive to one’s personal learning style, reviewing some material on a daily basis, and staying abreast of various tips and tricks to help answer the trickiest of practice test questions.

A diligent student engages in self-discovery to pinpoint the manner in which he or she learns most optimally. Even though a wide array of different theories exist regarding adult learning styles, it is best to simplify things by asserting that a pupil can be a visual learner, auditory learner, tactile learner, kinesthetic learner, or perhaps a combination of two or more learning styles.

It has also been said that repetition is the mother of all learning. Learning by repetition is a valid way of becoming proficient at answering knowledge-based questions. Simply put, the more a nurse aide student answers practice questions, the more prepared he or she will be at the testing center when answering the real exam questions on the knowledge (or oral) section of the CNA state test.

One proven way of boosting a skill proficiency or becoming competent at a task is to ensure that it is a stored routine in the consciousness of the learner. To make sure this process takes place, the most imperative first step is to elevate the skill to a conscious level whereby the nurse aide student deliberately ruminates over the activity, but not necessarily the desired skill itself.

In other words, the nurse aide student has full knowledge about the particular skill that he or she lacks (read: answering knowledge-based test questions) and, therefore, focuses on accomplishing the types of activities that will help him or her build the skill (e.g., reading, creating flashcards, repeatedly answering practice questions). This type of learning is what educators commonly refer to as learning by repetition.

To prepare adequately for the written knowledge section of the CNA state test, a nurse aide student should answer multiple practice questions each and every day. Click on the video below to see a handful of examples of the types of questions that will appear on the written portion of the CNA state test.

Texas CNA Skills (Part Nine): Skills on the CNA State Test that Require Measurements

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The National Nurse Aide Assessment Program, or NNAAP for short, is a nationwide credentialing program for nurse aides who want to pursue certification as a certified nursing assistant (CNA). In other words, the NNAAP exam is better known as the CNA state test. Additionally, the National Council of State Boards of Nursing (NCSBN) is the entity that has been entrusted with the formulation, revision and administration of the CNA state test.

In most states in the US, the CNA state test is comprised of two distinct sections: a written (or oral) knowledge test made up of 70 multiple choice questions, and a procedural skills competency evaluation consisting of five different hands-on skills that must be demonstrated in front of a nurse aide evaluator.

The procedural hands-on skills evaluation section of the CNA state test takes place in a setting that has been arranged to simulate a patient care environment such as a room inside a long term care facility. Each test taker will have exactly 30 minutes to demonstrate competency in the five skills. The nurse aide candidate must attain a passing cut score on four out of the five procedural skills in order to pass the skills evaluation section of the CNA state test.

The first procedural skill that all test takers in Texas complete is hand-washing, and the remaining four skills will be selected totally at random. Moreover, the NNAAP skills evaluation mandates that all test takers complete at least one numerical measurement skill as part of the CNA state test (Pearson Vue, 2018). All of the hands-on procedural skills that require documentation of a numeric measurement have been listed below.

  1. Measurement and documentation of blood pressure
  2. Measurement and documentation of respiration rate
  3. Measurement and documentation of radial pulse
  4. Measurement and documentation of urinary output
  5. Measurement and documentation of an ambulatory patient’s body weight

On the scheduled day of the CNA state test, the test taker will need to bring three sharpened number two pencils with erasers to the testing center site to record the numerical measurements. The test taker will also need to bring a wristwatch with a second hand to the testing center to perform certain skills.

During the CNA state test, nurse aide test takers in Texas will be using the following standardized, approved form to document the numerical measurement(s) of the random procedural skill(s) they have been assigned.

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REFERENCES

National Council of State Boards of Nursing. (2018). NNAAP & MACE. Retrieved from https://www.ncsbn.org/nnaap-and-mace.htm

Pearson Vue. (2018). Texas Nurse Aide Candidate Handbook. Retrieved from https://home.pearsonvue.com/getattachment/73a0c524-4cbe-401a-aa5c-fe1ebf4e2517/Texas