Texas CNA Skills (Part Eight): What to Wear and How to Dress for the CNA State Test

person performing cpr on dummy
Photo by rawpixel.com on Pexels.com

The broad majority of states in the U.S. have enacted laws that require graduates of nurse aide training programs to pass the respective state-approved examination in order to secure occupational certification as a certified nursing assistant (CNA). Therefore, the CNA state test is extremely important to the future career prospects of countless nursing assistants.

Nonetheless, many nurse aide students remain blissfully unaware that a testing center dress code exists. Well, a dress code certainly does exist for the CNA state test, and more than one rationale for being dressed in a specific way at the testing center site has been presented. The rationales for the dress code have been listed below.

  1. Nurse aide test takers should anticipate the remote possibility of spending all day at the testing center. Therefore, all-day comfort is of the utmost importance.
  2. A nurse aide test taker might be asked to participate in a simulated patient care environment where he or she plays the role of a debilitated elderly patient for one or more other test takers who need to perform hands-on skills. Thus, nurse aide candidates will actually be performing their skills on each other during the skills evaluation section of the CNA state test.
  3. Nurse aide test takers should wear shoes with non-skid soles (bottoms) for safety reasons. The safety of all test-taking candidates needs to be upheld at the testing center.
  4. Any candidate who volunteers to play the role of the patient must wear flat slip-on non-skid closed toe shoes, loose pants or bottoms that are capable of being rolled up, and a loose tank top or loose-fitting shirt with sleeves that can be rolled up to the shoulders (Pearson Vue, 2018).

In general, test takers will never go wrong by dressing the part of an employed nursing assistant regardless of whether or not they opt to volunteer to pose as a patient. The following dress code is more of a basic set of guidelines for appropriate testing center clothing for the CNA state test. Keep in mind that Pearson Vue testing centers are the testing sites where all CNA state tests are conducted in the state of Texas. The following list contains generalities surrounding proper attire in regards to the Texas CNA state test, as well as testing sites in the majority of other states in the US.

  1. Wear closed-toe shoes with flat non-skid soles.
  2. Nurse aide test takers who do not volunteer to play the role of a patient should wear a medical uniform, scrub set, or casual attire. Clothing should be clean.
  3. Nurse aide test takers who choose to wear casual attire should wear jeans, pants, khakis or slacks to comply with the potential need for hands-on skills practice. Dresses and skirts are discouraged with the exception of religious reasons.
  4. Midriffs and abdominal areas should be covered.
  5. Nurse aide test takers should appear clean, groomed, and be free from strong body odor. Perfumes, body sprays and colognes are discouraged.
  6. Nurse aide test takers who wear white bottoms should wear proper underwear since patterned panties, briefs or boxer shorts might be seen through white material.
  7. Long hair should be worn back into a ponytail, bun, contained by a headband, or pinned.
  8. Fingernails should be kept short and trimmed.
  9. Nurse aide test takers must wear a wristwatch with a second hand.
  10. Limit / curtail the amount of jewelry worn to the testing center. The amount of jewelry the nurse aide test taker wears to the testing center site should be minimal.

image (4)

Be completely mindful that the CNA state test dress code is different in a handful of states in the US. For example, CNA state test sites in Arizona require all test-taking candidates to adhere to a very specific dress code, and those who do not comply will not be permitted to take the exam.

With regards to the CNA state test in Arizona, Headmaster LLP (2018) asserts that “SCRUBS (which consists of a scrubs top and scrub pants, scrub skirt (long, loose-fitting) or scrub dress (long, loose-fitting) and closed-toed, soft-soled shoes are the required dress code for testing. You will not be admitted for testing if you are not wearing scrub attire and the appropriate shoes. You will be considered a NO SHOW. You will have to pay for another exam date.”

Be sure to dress for success on the day of the CNA state test and beyond. The nurse aide testing site evaluator is the individual who will be observing for competency as the test taker performs the skills evaluation section of the state test. Dressing the part for the CNA state test can go a long way in presenting the image of a candidate who is fully competent, prepared, professional, and serious about his or her future career as a nursing assistant.

Readers have probably heard the olden adage that one never gets a second chance to make a first impression. The point is to present oneself to the testing site evaluator as a nurse aide who deserves to pass the CNA state test. A cleanly nurse aide candidate looks the part, whereas a test taker with 10 gold chains, a tight-fitting cropped top that exposes the torso and dirty blue jeans does not look professional.

REFERENCES

Headmaster, LLP. (2018). Arizona Nursing Assistant Candidate Handbook. Retrieved from http://hdmaster.com/testing/cnatesting/arizona/azformpages/azforms/AZCandidateHandbook%202.1.18.pdf

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

 

 

 

Advertisements

Texas CNA Skills (Part Seven): Critical Element Steps in the Skills Competency Section of the CNA State Test

person taking blood pressure
Photo by rawpixel.com on Pexels.com

Nursing assistants who want to obtain certification as a certified nursing assistant (CNA) will need to pass the CNA state examination for the state where they plan to work. In the state of Texas, the CNA state test consists of two sections: a written (or oral) examination with a series of 70 multiple choice questions, as well as a hands-on skills competency evaluation consisting of five procedural skills that are to be performed in the presence of a testing site nurse aide evaluator.

During the skills section of the CNA state test, all test takers will need to successfully perform hand washing as the first procedural skill. Thereafter, the test taker will be required to perform an additional four out of five testable procedural skills. The remaining four testable skills will be selected completely at random.

Before the skills evaluation section of the CNA state test starts, the testing site nurse aide evaluator hands the test taker an instruction card that lists the randomly selected procedural skills that must be completed. Hand washing is the only CNA state test procedural skill that is not selected randomly. In other words, all nurse aide candidates who take the Texas CNA state test will be assigned the skill of hand washing during the skills evaluation portion.

Critical element steps are also referred to as critical steps, key steps, critical items, and critical elements. According to Pearson Vue (2018), critical element steps are the important actions associated with each procedural skill that the test taker must complete with accuracy in order to pass that particular skill. In other words, critical element steps are actions that must always be performed when completing a skill in front of the testing center nurse aide evaluator during the CNA state test.

image (1)

A nursing assistant candidate will most certainly fail the hands-on skills evaluation section of the CNA state test if he or she forgets to perform, misses, or incorrectly performs any critical element steps associated with a particular procedural skill. Also, be advised that most, but not all, skills have critical element steps that need to be correctly done in order to successfully complete the entire procedure with a passing cut score.

As an example, the procedural skill of cleaning an upper or lower denture has no critical element steps associated with it. However, the skill of measuring and recording a patient’s respirations has at least one critical element step attributed to it. Missing, forgetting, or incorrectly completing the critical element step associated with measuring and recording respirations means that the test taker fails the entire skill.

The skill of measuring and recording a patient’s respiratory rate is listed below in a step by step sequence, along with the single critical element step associated with this procedure. The critical element step is emboldened and underlined.

  1. The nursing assistant explains the procedure using clear and slow speech that is understandable. The nursing assistant maintains face to face contact with the client as much as possible.
  2. The nursing assistant measures the client’s respiration rate for one whole minute.
  3. The nursing assistant makes sure that the client’s call bell or signaling device is within reasonable reach.
  4. The nursing assistant washes his or her hands before documenting the client’s respiration rate.
  5. The nursing assistant is to document a respiration rate number that falls approximately within plus or minus two breaths of the testing site nurse aide evaluator’s documented number.

In general, most provisions related to safety, privacy, numerical measurements and infection control are usually regarded as critical element steps for testing purposes while taking the skills competency section of the CNA state test. The test taker cannot miss any critical element steps while performing a hands-on procedural skill at the testing center, or else he or she will automatically fail that particular skill.

In fact, most failures on the skills evaluation portion of the CNA state test can be attributed to the test taker’s omission or forgetfulness of the critical element steps on procedural skills regarding client safety, rights, numerical measurement documentation, or privacy maintenance. In summary, do one’s best to avoid missing any critical element steps at the testing center.

REFERENCES

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

 

 

 

Texas CNA Skills (Part Six): the Art of Nurse Aide Communication on the CNA State Test

person getting his blood check
Photo by Pranidchakan Boonrom on Pexels.com

Communication can be defined as the ongoing exchange of data, information, thoughts, opinions and feelings among persons by way of utilizing speech, gestures and/or other means (Kourkouta and Papathanasaiou, 2014). Since nursing assistants are on the front lines of direct care in healthcare facilities, the communication skills of CNAs are truly fundamental to smooth interpersonal interactions and enhanced patient satisfaction.

Communication between nursing assistants and their patients is firmly grounded in a trifecta of three essential elements. These three elements include competent social skills, proven communicative techniques, and the Golden Rule of always treating other individuals in the same manner that one would want to be treated.

The communication of each nursing assistant is also guided by several ethical principles. First of all, veracity is defined as truth-telling. Nursing assistants possess the ethical obligation to be truthful (read: veracious) in all communications with their patients. Secondly, the ethical principle of integrity imposes a duty upon all nursing assistants to behave in a straightforward manner while adhering to high standards in all communications and encounters with patients. Finally, the ethical principle of fidelity is defined as being faithful, and nursing assistants have the ethical obligation to exercise faithfulness when communicating with patients.

Communication is also an element that is heavily tied into the skills portion of the CNA state test. The test taker will need to communicate with a patient in a simulated patient care scenario as a testing site evaluator observes. The vast majority of the hands-on procedural skills involve some type of verbal and nonverbal communication in order to pass the CNA state test. For instance, most of the skills on the CNA state test call upon the nurse aide test taker to engage in multiple communicative tasks.

The communicative tasks that are incorporated into the skills portion of the CNA state test often include verbal and nonverbal responsibilities such as introducing oneself as the nursing assistant, vocally identifying the patient, referring to the patient by his or her preferred name, explaining the procedure, maintaining face to face contact whenever possible, and asking if anything else is needed.

The following list is a set of general guidelines on communicating clearly and effectively with patients during the skills competency evaluation section of the CNA state test.

  1. The nursing assistant should greet the patient by his or her preferred name.
  2. The nursing assistant should introduce himself or herself to the patient by announcing one’s name and title (e.g., “My name is Rob and I will be your nursing assistant today.”).
  3. The nursing assistant should maintain face to face contact with the patient whenever possible.
  4. The nursing assistant should avoid staring into space or talking aimlessly. The nursing assistant should focus on the topic to be discussed.
  5. The nursing assistant should occasionally talk to the patient while providing the care.
  6. The nursing assistant should listen to the patient as he or she speaks and respond as needed.
  7. The nursing assistant should utilize appropriate social reinforcements such as praise, smiling, and rephrasing of the patient’s words as needed.
  8. The nursing assistant should encourage the patient to utilize the call light as needed and make sure it remains within easy reach.
  9. The nursing assistant should be cordial, even-tempered and honest in all verbal and nonverbal interactions with the patient.
  10. The nursing assistant should let the patient know verbally when he or she is preparing to exit the room.

REFERENCES

Kourkouta, L., and Papathanasaiou, I. (2014). Communication in Nursing Practice. Materia Sociomedica, 26(1), 65-67.

Texas CNA Skills (Part Four): Ending Steps, a.k.a. “Closing Procedures” After Completion of Each Skill on the State Test

red school blur factory
Photo by Gratisography on Pexels.com

In the vast majority of U.S. states, Texas included, a nurse aide candidate who intends to be successful on the the CNA state-approved examination for certification as a certified nursing assistant will need to demonstrate his or her abilities to correctly perform a series of hands-on procedural tasks during the skills section of the state test.

Of course, the demonstration of skills competency is occurring at the testing center in the midst of a simulated scenario. Additionally, an examiner is carefully eyeballing the test-taking candidate for evaluation purposes while he or she is performing the myriad of steps required to complete each skill performance from beginning to conclusion.

A grand total of 22 testable skills exist on the skills portion of the CNA state test in Texas that a test taker might be called upon to perform. Furthermore, five of the 22 skills are chosen randomly for the test taker to perform from start to finish in the presence of the examiner to demonstrate competency.

The test taker will pass the skills section of the CNA state test if he or she correctly performs four out of five of the randomly selected skills that have been assigned. Hence, it is imperative for the test taker to be completely prepared prior to the testing date by possessing thorough knowledge on how to accurately perform all 22 testable skills.

As a reminder, the test taker is permitted to miss a small, predetermined number of steps that have been deemed not critical and still be able to pass the skills section of the CNA state examination for certification. The main idea is that examiner is observing to ensure that the test-taker knows how to complete all steps associated with each procedural skill.

Nonetheless, be advised that the nurse aide candidate is strictly not permitted to miss or fail to perform any critical steps of a procedural skill during the skills portion of the Texas CNA state test. Customarily, provisions related to infection control (read: hand hygiene), maintenance of a safe environment (read: bed in low position and side rails up), upholding patient privacy (read: keeping doors and privacy curtains closed) and ensuring a signaling device or call light remains within reasonable reach are considered critical steps.

To recap, critical steps are ones that need to always be performed when demonstrating skills competency at the testing center during the CNA state test. A test taker will fail the skills competency section of the CNA state examination if any critical steps associated with a particular skill are missed or forgotten. For instance, forgetting to wash one’s hands after removal of gloves would be a missed critical step since hand hygiene is an essential aspect of infection control.

Ending steps are known by a number of differing names, including post-steps, completion steps, ending procedures and closing procedures. Due to the fact that the skills section of the CNA state exam is normally completed as part of one simulated scenario, the closing procedures must be completed once, usually when the scenario is ending. To reemphasize, test takers need to carry out these closing procedures at the end of each CNA state test.

Closing procedures tend to entail routine nursing care steps such as making sure that the patient’s call light or signaling devise is within easy reach, ensuring comfort measures, lowering the bed to a safe position, raising or lowering the bed’s side rails in accordance with the patient’s plan of care, performing hand hygiene, and documenting. According to Professional Healthcare Development (2011), the closing procedures should be completed in the following sequence:

  1. The nursing assistant should utilize proper body mechanics during the performance of all skills.
  2. The nursing assistant should position the patient for comfort. The nursing assistant should position the patient in appropriate body alignment.
  3. The nursing assistant must adjust the bed’s side rails per physicians’ orders and lower the bed.
  4. The nursing assistant should ensure the patient has everything they will need. The nursing assistant should take the time to thank the patient.
  5. The nursing assistant should maintain the cleanliness of the patient’s room per facility policies.
  6. The nursing assistant must remove his or her gloves and wash the hands as the situation dictates.
  7. The nursing assistant should offer to open privacy curtains and doors in accordance with the wishes of the patient.
  8. The nursing assistant must observe the environment for safety, always ensuring that the call light remains within reasonable reach.
  9. The nursing assistant must report any abnormal findings to the nurse.
  10. The nursing assistant must document per facility policies and procedures.

RESOURCES

Lindsey, Carol. (2010). Ending Procedures (video). Retrieved from https://www.youtube.com/watch?v=TzgyjUcC080

Professional Healthcare Development, LLC. (2011). Performance Skill Procedures. Retrieved from http://www.profhd.com/Skills%20procedures.pdf

Texas CNA Skills (Part One): Hand-Washing, a.k.a. Hand Hygiene Instructions and Video

cooking hands handwashing health
Photo by Burst on Pexels.com

Hand-washing is arguably one of the easiest and most effectual methods of infection control in healthcare facilities. Correctly-performed hand hygiene prevents the spread of harmful diseases. In fact, the overarching goal of hand-washing is to remove microbes, dirt, debris and particles from the hands by way of sufficient manual friction along with soap and warm water to prevent the spread of disease-causing germs to vulnerable patients and residents.

In addition, hand-washing happens to be a testable skill on the Texas state examination and skills evaluation test to attain certification as a certified nursing assistant (CNA). During the course of the CNA state test, the test-taker is expected to perform a full hand-washing skill sequence in front of the examiner to ensure that it is being done properly. Thus, a thorough working knowledge of correct hand-washing techniques is imperative in order for a candidate to pass the skills portion of the state exam.

Without satisfactory knowledge of hand-washing techniques, a test taker could quite possibly fail the skills portion of the state test, resulting in a disappointing loss of time, money, effort and confidence. Who wants to continually retake the CNA state exam? Not you! In other words, it would be an excellent idea to know how to perform the skill of hand-washing in the precise manner that the state test examiner wants it completed.

CNAs and other healthcare workers will need to wash their hands multiple times per work shift during the course of performing direct care. The nurse aide must perform proper hand hygiene before entering patients’ rooms, prior to exiting patients’ rooms, before and after feeding residents, after handling unclean bedding and linens, prior to performing procedures on patients, and after coming into contact with skin tears and open wounds.

Again, the rationale for hand-washing is to reduce the likelihood of transmitting infectious germs. The World Health Organization (2009) asserts that five instances are appropriate for hand hygiene: 1) prior to contact with patients and residents; 2) prior to performing clean and/or aseptic tasks; 3) after body fluid exposure risks; 4) after contact with patients and residents; 5) after making contact with patients’ surroundings.

Screenshot 2018-11-30 at 9.58.40 PM.png

To successfully complete the hand-washing skill for the Texas CNA state exam, Pearson Vue (2018) asserts that this procedure should be performed utilizing the following steps in the order that has been listed below:

  1. The nursing assistant must refer to the patient by his or her name. The nursing assistant must also introduce himself or herself to the patient by name.
  2. The nursing assistant must proceed to turn on the water faucet at the sink.
  3. The nursing assistant needs to completely wet his or her hands and wrists.
  4. The nursing assistant adds a sufficient amount of soap to his or her hands.
  5. The nursing assistant must ensure all surfaces of his or her hands, wrists and fingers are lathered up for a minimum of 20 seconds while using sufficient friction. While lathering up, make sure the hands remain lower than the elbows. While lathering up, also make sure elbows and fingertips are kept down.
  6. The nursing assistant needs to clean his or her fingernails by rubbing the fingertips against the palms of the opposite hand.
  7. The nursing assistant must rinse off all surfaces of his or her hands, wrists and fingers while being sure to keep the hands lower than the elbows and the fingertips down.
  8. The nursing assistant must use dry paper towels to dry off all surfaces of his or her hands, wrists and fingers while starting at the fingertips. The nursing assistant then must proceed to dispose of the used paper towels into the wastebasket receptacle.
  9. The nursing assistant must use dry paper towels to turn the water faucet off before properly throwing the used paper towels into the wastebasket receptacle.
  10. The nursing assistant must not touch the inside of the sink during any point in time while performing the hand-washing skill in front of the examiner.

REFERENCES

All About Medical Training. (2015). Hand Hygiene (Hand Washing) CNA Skill Video AAMT. Retrieved from https://www.youtube.com/watch?v=6ae0eODZyNQ&t=2s

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

World Health Organization. (2009). Hand Hygiene: How, Why & When? Retrieved from http://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf

Screenshot 2018-11-30 at 10.27.07 PM