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

black and white blood pressure kit
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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 Fourteen): the Five-Surface Wash Cloth Method for Perineal Care

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Perineal care, commonly referred to as peri-care, is the routine care that nurses, nursing assistants and caregivers perform on clients’ genital areas and buttocks to maintain cleanliness, eliminate unpleasant odors, and reduce the microorganism count on this part of the body. Perineal care is a state-testable skill that might randomly appear on a candidate’s CNA state exam, so knowing how to do all steps properly is important.

It is crucial that nurse aides know how to perform perineal care correctly since the client’s perineal area has the potential of becoming infected if this skill is not done the right way. Proper perineal care promotes comfort, infection control, safety and privacy. When performing this skill, always provide for the client’s privacy and wipe from front to back to avoid introducing germs from the anus and buttocks into the urinary tract.

Since the client’s comfort should be kept in mind throughout the procedure, be very gentle and careful when performing perineal care because this part of the body can be extremely sensitive to extremes in touch and temperature. The necessary supplies to perform this skill include a pair of gloves, a wash basin, lukewarm water, soap, six wash cloths, two bath towels, and two bed protectors (also known as ‘chucks’).

To maintain cleanliness and prevent infections, take the extra time to use a new part of the wash cloth with each wipe to ensure that a clean area of the cloth is always being used. Legacy Healthcare Careers recommends the five-surface method for using wash cloths while providing perineal care at the CNA state test. If executed the right way, the five-surface method enables nurse aides to use five different parts of one wash cloth.

The five-surface method has a couple of benefits. First of all, it provides a clean part of the wash cloth for each wipe, and this is important for achieving a passing score on the perineal care skill at the CNA state exam. Second of all, it keeps the nurse aide from going through too many wash cloths, and this can be immensely helpful when working at a healthcare facility that experiences ongoing shortages of clean linens.

To use the five-surface method, get a wash cloth and fold it in half, then fold it in half a second time to end up with a smaller wash cloth. Thereafter, hold the wash cloth with the four corners pointed upward. Use the first corner of the wash cloth to wipe one area. Then fold the first corner downward and wipe another area with the second corner. Continue to fold each corner until the back of the wash cloth, which will be used as the fifth wiping surface, is reached.

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In essence, the five-surface method purposely involves use of five different parts of the wash cloth for wiping the client while performing perineal care:

  • the first corner
  • the second corner
  • the third corner
  • the fourth corner
  • The back of the wash cloth

REFERENCES

Tanner, D. (2019). How to Give Perineal Care. Retrieved April 28, 2019, from https://www.caregiverology.com/perineal-care.html